Penerapan Intervensi Mendengarkan Murottal Al-Quran Terhadap Penurunan Tekanan Darah Pada Lansia

Elderly is someone who enters teh age of 60 years or more and experiences physical and physiological changes. Health problems that are commonly experienced by the elderly are hypertension. Hypertension is a health problem characterized by an increase in systolic and diastolic blood pressure of more than 140/90 mmHg. Non-pharmacological action that is useful in reducing blood pressure is listening to murottal Al-Quran therapy. The purpose of the action is to reduce blood pressure in the elderly with hypertension. This research used the case study method of gerontic nursing care with the therapeutic technique of listening to Al-Quran murottal. The application of Al-Quran murottal listening intervention which was carried our for 7 visits was proven to redue blood pressure in the elderly. The first clien’t initial blood pressure was 170/100 mmHg to 120/90 mmHg (the average drop in systolic pressure is 45-50 mmHg and diastolic is 10 mmHg), while the second clien’t initial blood pressure was 175/100 mmHg to 120/100 mmHg(the average drop in systolic pressure is 45-50 mmHg and diastolic is 10 mmHg). this result can be used as a consideration for nurses to provide Al-Quran murottal therapy as an alternative nursing action for the elderly with hypertension.Keywords : Hypertension, Elderly, Al-Quran Murottal listening therapy AbstrakLansia merupakan seseorang yang memasuki usia 60 tahun atau lebih dan mengalami perubahan fisik maupun fisiologis, salah satu masalah kesehatan yang biasa dialami lansia adalah hipertensi. Hipertensi merupakan masalah kesehatan dengan ditandainya kenaikan tekanan darah sistolik dan diastoliknya lebih dari 140/90 mmHg. Tindakan non-farmakologi yang bermafaat dalam penurunan tekanan darah yaitu terapi mendengarkan murottal Al-Quran. Tujuan dilakukan tindakan yaitu untuk menurunkan tekanan darah pada lansia hipertensi. Karya Tulis Ilmiah ini disusun dengan menggunakan metode studi kasus asuhan keperawatan gerontik dengan teknik terapi mendengarkan murottal Al-Quran. Penerapan terapi mendengarkan murottal Al-Quran yang dilakukan selama 7 kali kunjungan terbukti dapat menurunkan tekanan darah pada lansia. Lansia klien 1 dengan tekanan darah awal 170/100 mmHg menjadi 120/90 mmHg (rata-rata penurunan tekanan sistolik 45-50 mmHg dan diastoliknya 10 mmHg), klien lansia 2 dengan tekanan darah awal 175/100 mmHg menjadi 120/100 mmHg mmHg (rata-rata penurunan tekanan sistolik 45-50 mmHg dan diastoliknya 10 mmHg). Perawat diharapkan dapat memberikan terapi Murottal Al-Quran secara maksimal sebagai salah satu alternatif tindakan keperawatan bagi lansia dengan hipertensi.Kata kunci : Hipertensi; Lansia, Terapi Murottal Al-Quran

Blood pressure monitoring following individual carpules of anesthetic utilizing computer-controlled anesthetic delivery

To date, no study has evaluated blood pressure following administration of each carpule given for dental procedures using a computerized dental anesthesia system. Blood pressures taken prior to performing invasive periodontal procedures were compared with those readings measured following delivery of each of up to three consecutive carpules of Marcaine or Xylocaine in varying order. Pressure differences were also adjusted for age, sex, race, and whether a prescribed anxiolytic was taken beforehand. Neither systolic nor diastolic blood pressures changed significantly as compared to initial blood pressure readings. However, compared with Whites, Hispanics, and Middle Easterners, Blacks had significantly higher systolic pressure at the third carpule delivery, the cause being unknown. Blood pressure in patients being anesthetized for root planing and various periodontal surgical procedures will not increase significantly when administering up to three carpules, whether Marcaine or Xylocaine, in varying order, using controlled flow dental anesthesia, and this method may be preferable to syringes in managing dental procedural stress.

Gambaran Perubahan Tekanan Darah Pasca Olahraga Futsal pada Mahasiswa Fakultas Kedokteran Universitas Andalas

AbstrakPada olahraga tertentu seperti futsal, tekanan darah dapat naik menjadi 150-200 mmHg. Sebuah penelitian menyatakan 60 kematian mendadak pasca olahraga, 58 diantaranya disebabkan oleh kelainan kardiovaskuler. Tujuan penelitian ini adalah untuk mengetahui gambaran perubahan tekanan darah pasca olahraga futsal pada mahasiswa Fakultas Kedokteran Universitas Andalas. Rancangan penelitian yang digunakan adalah deskriptif observasional dengan menggunakan desain cross-sectional study. Subjek yang digunakan adalah 30 orang mahasiswa Fakultas Kedokteran Universitas Andalas yang memenuhi kriteria inklusi dan eklusi pada April 2014. Olahraga futsal dilakukan 30 menit lalu dilakukan pengukuran tekanan darah sesaat, 15, 30 dan 60 menit dengan menggunakan sphygmomanometer air raksa dan stetoskop. Hasil penelitian didapatkan peningkatan tekanan darah sistolik sesaat setelah olahraga futsal pada semua sampel dengan peningkatan sebesar 20 mmHg pada 18 orang (60%) dan 25 orang (83,8%) tidak mengalami perubahan tekanan darah diastolik. Pada 15 menit setelah olahraga futsal, 18 orang (60%) terjadi penurunan tekanan darah sistolik sebesar 20 mmHg dan 26 orang (86,67%) tidak mengalami perubahan tekanan darah diastolik. Pada 30 menit setelah olahraga, 4 orang (13,3%) mengalami penurunan tekanan darah sistolik. Satu jam setelah olahraga, semua subjek telah mencapai tekanan darah awal.Kata kuncl: tekanan darah, olahraga futsal sesaat, 15 menit, 30 menit, satu jam AbstractIn certain exercise such as futsal, blood pressure can raise around 150-200 mmHg. A study has identified 60 sudden deaths after sports and 58 were caused by cardiovascular disorders. The objective of this study was to describe changes in blood pressure after futsal exercise in students of Medical Faculty of Andalas University. The design is descriptive observational using a cross-sectional study. The 30 subjects were taken base on inclusion and exclusion criteria. This study was conducted on April 2014. Subject played futsal for 30 minutes, then the blood pressure was measured right after doing futsal then 15, 30 and 60 minutes later with a sphygmomanometer and stethoscope. This study found an increase in systolic blood pressure shortly after futsal in all subjects with an increase of 20 mmHg in 18 people (60%) and 25 people (83.8%) had no change in diastolic blood pressure. Fifteen minutes after doing futsal, 18 people (60%) had 20 mmHg decrease in systolic blood pressure and 26 (86.67%) had no change in diastolic blood pressure. Thirty minutes after doing futsal, 4 (13.3%) experienced a decrease in systolic blood pressure and 100% returned to the initial blood pressure. One hour after exercise, all of subjects reached the initial blood pressure again.Keywords: blood pressure, right after doing futsal, 15 minutes, 30 minutes, one hour

Abstract T P399: Patient Characteristics and Outcomes in Pregnancy-Related Subarachnoid Hemorrhage

Background: Subarachnoid hemorrhage (SAH) accounts for up to 4.1% of all pregnancy-related in-hospital deaths, but is less often aneurysmal and is associated with better short term outcomes than in non-pregnant patients. We sought to describe the risk factors, management and outcomes of pregnant vs. non-pregnant patients with SAH in the Get With The Guidelines (GWTG) Stroke Registry. Methods: Using medical history or ICD-9 codes, we identified 152 pregnant and 5745 non-pregnant SAH female patients aged 18-44 with SAH in GWTG from 2008-2013. Differences in characteristics were compared by Chi-square tests for categorical and Wilcoxon Rank-Sum tests for continuous variables. Stratified logistic regression assessed the effect of pregnancy on outcomes conditional on age and adjusted for patient and hospital characteristics. Results: Pregnant SAH patients were younger, more often black and insured with Medicaid. They had higher initial blood pressure (BP) and were less likely to report prior hypertension. Arrival delays from stroke onset were common in both groups (median 340 vs. 277 min), but pregnant SAH patients were more often already hospitalized at stroke onset (16% vs. 10%). Fewer pregnant vs. non-pregnant SAH patients had initial neurologic exam findings recorded (Table). Pregnant SAH patients had lower in-hospital death than non-pregnant patients (aOR 0.17, 95% CI 0.06-0.45) and were more likely at discharge to ambulate independently (aOR 2.40, 95% CI 1.56-3.69) and return home (aOR 2.60, 95% CI 1.67-4.06). Conclusions: Several differences exist between pregnant and non-pregnant women with SAH. Many present with BP well below the threshold for hypertensive disorders of pregnancy, making prompt recognition and prevention of brain hemorrhage challenging. Overall, pregnancy-related SAH is associated with less morbidity and mortality than non-pregnancy related disease.

Abstract W P126: Accurate Outcome Predictions for Intracerebral Hemorrhage Patients Are More Likely Than Inaccurate Predictions to Be Influenced by Co-morbidities Not Included in Clinical Scales

Introduction: Clinical scales for intracerebral hemorrhage (ICH), such as the ICH and FUNC Scores, utilize a limited number of variables for outcome prediction. The variables that physicians incorporate into subjective predictions of ICH outcome and how they relate to predictive accuracy are unknown. Hypothesis: Accurate physician predictions of functional outcome for ICH patients are more likely than inaccurate predictions to incorporate decision-making factors outside of the variables comprising the ICH and FUNC Scores. Methods: For each consecutive adult patient admitted with primary ICH at 5 centers, one physician on the treatment team was surveyed for a prediction of modified Rankin Scale (mRS) at 3 months. All predictions were prospectively collected within 24 hours of admission. Physicians were also asked to indicate up to 10 factors influencing their prediction. Accuracy was defined as an exact prediction of the mRS obtained for each patient at 3 months. The frequency of recurring factors listed by physicians were calculated for both the accurate and inaccurate predictions and compared using Fisher’s exact test. Results: We collected 38 accurate and 86 inaccurate predictions for 124 ICH patients. There was no difference between groups with regards to the proportion of respondents listing age, ICH volume, or general clinical exam on admission as factors. However, 16 (42.1%) of the accurate surveys listed the patient’s general co-morbidities as a factor in prediction, compared to 20 (23.3%) of inaccurate surveys (p = 0.05). Listing of pre-morbid functional status as a factor also trended towards a higher percentage in the accurate survey group (n = 7, 18.4%, versus n = 6, 7.0%; p = 0.11). Of note, all surveys that cited the etiology of the bleed (n = 5), the initial blood pressure (n= 4), and the presence or absence of an extraventricular drain (n = 7) as influencing factors contained either overly optimistic or pessimistic predictions. Conclusions: Accurate predictions of ICH outcome are more likely than inaccurate predictions to factor in general patient co-morbidities, which are not included in ICH or FUNC Score calculation.

Prehospital Intubation in Patients with Isolated Severe Traumatic Brain Injury: A 4-Year Observational Study

Objectives. To study the effect of prehospital intubation (PHI) on survival of patients with isolated severe traumatic brain injury (ISTBI).Method. Retrospective analyses of all intubated patients with ISTBI between 2008 and 2011 were studied. Comparison was made between those who were intubated in the PHI versus in the trauma resuscitation unit (TRU).Results. Among 1665 TBI patients, 160 met the inclusion criteria (105 underwent PHI, and 55 patients were intubated in TRU). PHI group was younger in age and had lower median scene motor GCS (P=0.001). Ventilator days and hospital length of stay (P=0.01and 0.006, resp.) were higher in TRUI group. Mean ISS, length of stay, initial blood pressure, pneumonia, and ARDS were comparable among the two groups. Mortality rate was higher in the PHI group (54% versus 31%,P=0.005). On multivariate regression analysis, scene motor GCS (OR 0.55; 95% CI 0.41–0.73) was an independent predictor for mortality.Conclusion. PHI did not offer survival benefit in our group of patients with ISTBI based on the head AIS and the scene motor GCS. However, more studies are warranted to prove this finding and identify patients who may benefit from this intervention.