ASUHAN KEPERAWATAN KEPERAWATAN MEDIKALBEDAH PADA KLIEN DENGAN STEVENS-JOHNSONBAB IPENDAHULUAN1.1.Latar BelakangSindromSteven-Jo!non" #i$$n%$diin&'$t'$ne#$&$i SJS" $d$($!re$'i #)r)'%$n&$n&$t &$*$t ter!$d$+ o#$t, E-e' $m+in& o#$t ini mem+en&$r)!i ')(it" ter)t$m$ e($+)tm)'o$, Predi'i . m)()t" m$t$" ')(it" &in/$(" d$n $n),Sindrom ini /$r$n& di/)m+$i +$d$ )i$ 0 t$!)n" 'e#$*$! 'em)di$n )m)rn%$ #erv$ri$i d$ririn&$n$m+$i #er$t, P$d$%$ner$t 'e$d$r$nn%$men)r)n" +enderit$d$+$t o+oro)$m+$i'om$" m)($in%$ +en%$'it $')t d$+$t diert$i &e/$($ +rodiom$( #er)+$ dem$m tin&&i" m$($ie" n%eri'e+$($" #$t)'" +i(e' d$n n%eri ten&&oro'$n,SindromStevenJo!nonditem)'$no(e!d)$do'ter$n$'Ameri'$, A,M, Stevend$nS,1Jo!non" 2334 Sindrom Steven Jo!non %$n& #i$ diin&'$t SSJ mer)+$'$n re$'i $(er&i %$n& !e#$tter!$d$+ o#$t-o#$t$n,An&'$ 'e/$di$n Sindrom Steven Jo!non e#en$rn%$ tid$' tin&&i !$n%$ e'it$r 2-25 +er 2 /)t$+end)d)', SindromStevenJo!nond$+$ttim#)( e#$&$i &$t$(-&$t$( !e#$t +$d$m)($n%$" dii')tiden&$n#en&'$'d$n'emer$!$n+$d$')(it,Sete($!#e#er$+$*$'t)"#i($o#$t%$n&men%e#$#'$ntid$' di!enti'$n" ert$ d$+$t tim#)( dem$m" $ri$*$n +$d$ m)()t" m$t$" $n)" d$n 'em$()$n ert$d$+$t ter/$di ()'$-()'$ e+erti 'ero+en& +$d$ ')(it, N$m)n +$d$ 'e$d$$n-'e$d$$n 'e($in$n itemim)n e+erti HIV d$n AIDS $n&'$ 'e/$di$nn%$ d$+$t menin&'$t e6$r$ t$/$m,D$ri d$t$ di$t$ +en)(i tert$ri' men&$n&'$t '$) Sindrom Steven Jo!non '$ren$ SindromSteven Jo!non $n&$t #er#$!$%$ #$!'$n d$+$t men%e#$#'$n 'em$ti$n, Sindrom tid$' men%er$n&$n$' di#$*$! 0 t$!)n" d$n +en%e#$# Sindrom Steven Jo!non endiri $n&$t #erv$ri$i $d$ %$n& d$rio#$t-o#$t$n d$n d$ri $(er&i %$n& !e#$t" d$n 6iri-6iri +en%$'it Steven Jo!non endiri &$t$(-&$t$( +$d$')(it d$n #$d$n 'emer$!-mer$!$n d$n Sindrom ini #erv$ri$i $d$ %$n& #er$t d$n $d$ %$n& rin&$n,7 S)++ort" Edii Novem#er 4889 :1.2.Rumusan Masalah2,A+$ +en&erti$n Steven Jo!non;4,A+$ etio(o&i d$ri Steven Jo!non;0,A+$ t$nd$ d$n &e/$($ Steven Jo!non;5,A+$ -$'tor +redi+oii Steven Jo!non;,A+$ $/$ +emeri'$$n +en)n/$n& )nt)' Steven Jo!non;9,B$&$im$n$ +en$t$($'$n$$n )nt)' indrom Steven Jo!non;3,Men&et$!)i $)!$n 'e+er$*$t$n +$d$ +en%$'it Steven Jo!non;1.3.Tujuan2,Men&et$!)i +en&erti$n Steven Jo!non;4,Men&et$!)i etio(o&i d$ri Steven Jo!non;0,Men&et$!)i -$'tor +redi+oii Steven Jo!non;5,Men&et$!)i t$nd$ d$n &e/$($ Steven Jo!non;,Men&et$!)i +emeri'$$n +en)n/$n& )nt)' Steven Jo!non;9,Men&et$!)i +en$t$($'$n$$n )nt)' S%ndrom Steven Jo!non;3,Men&et$!)i $)!$n 'e+er$*$t$n +$d$ S%ndrom Steven Jo!non;1..Man!aatAd$+)n m$n-$$t d$ri +en)(i$n m$'$($! ini $d$($! )nt)' men$m#$! +en&et$!)$n #$&i +em#$6$ tent$n& S%ndrom Steven Jo!non,BAB IIPEMBAHA"AN2.1. Pengert#an "te$en %&hns&nSindromSteven-Jo!non" #i$$n%$ diin&'$t'$ne#$&$i SSJ" $d$($!re$'i #)r)' %$n&$n&$t &$*$t ter!$d$+ o#$t, E-e' $m+in& o#$t ini mem+en&$r)!i ')(it" ter)t$m$ e($+)t m)'o$,J)&$ $d$ veri e-e' $m+in& ini %$n& (e#i! #)r)'" %$n&die#)t e#$&$i ne'ro(ii e+idermi to'i'7to?i' e+iderm$( ne6ro(%i@TEN:, Ad$ /)&$ veri %$n& (e#i! rin&$n" die#)t e#$&$i eritem$m)(ti-orme 7EM: 7Adit!$n"488=:,Sindrom Steven Jo!non d$($! indrom$ %$n& men&en$i ')(it" e($+)t (endir di ori-ii)m d$nm$t$ den&$n 'e$d$$n )m)m #erv$ri$i d$ri rin&$n $m+$i #er$t" 'e($in$n +$d$ ')(it #er)+$ eritem$"vei'e(@#)($" d$+$t diert$i +)r+)r$ 7 Mo6!t$r H$mA$!" 488< . 25> :Sindrom Steven Jo!non i$($! +en%$'it ')(it $')t d$n #er$t %$n& terdiri d$ri er)+i di ')(it"'e($in$n di m)'o$ d$n 'on/)n&tiviti7 K$+it$ Se(e't$ Kedo'ter$n" 2394 . 598 :Sindrom Steven Jo!non $d$($! +en%$'it ')(it $')t d$n#er$t %$n& terdiri d$ri er)+i ')(it"'e($in$n dim)'o$ d$n 'on/)n&ti-iti, 7 J)n$di" 2394. 598 :Sindrom Steven Jo!non$d$($! indrom 'e($in$n ')(it#er)+$ eritem$" vei'e(@#)($"d$+$tdiert$i +)r+)r$ %$n& men&en$i ')(it" e($+)t (endir %$n& ori-ii)m d$n m$t$ den&$n 'e$d$$n )m)m#erv$ri$i d$ri #$i' $m+$i #)r)', 7M$n/oer" A, 4888. 20= :,2.2. Et#&l&g#Pen%e#$# Steven Jo!non ini +$(in& #$n%$' di+i6) o(e! +en&&)n$$n o#$t-o#$t$n$t$) den&$n'$t$($in" +en%e#$#StevenJo!nonini $d$($!'$ren$$(er&i o#$t-o#$t tertent)" #i$$n%$$d$($!+en&&)n$$n o#$t $nti#ioti', Se($in $(er&i o#$t+en%e#$# ($inn%$ $d$($! '$ren$ $d$n%$ in-e'i vir)"#$'teri" $t$) /$m)r tertent)" '$ren$ m$'$n$n e+erti 6o'($t" 'etid$' 6o6o'$n (in&')n&$n mi$( )d$r$din&in" +$n$ m$t$!$ri d$n #$!'$n #i$ /)&$ di+i6) o(e! +en%$'it 'e&$n$$n ($inn%$ mi$( '$n'er,Se/)/)rn%$" +en%e#$# +$ti d$ri Steven Jo!non ini idio+$ti' $t$) tid$' e($() di'et$!)i e6$r$ +$ti"t$+i %$n&+$(in$n%$'ter/$di $d$($!'$ren$re$'i #er(e#i!$nd$ri t)#)!)nt)'meno($'o#$t-o#$t$n %$n& m$)' 'e d$($m t)#)!,A(er&i o#$t tererin&$d$($!&o(on&$no#$t $n$(&eti'7+ered$n%eri:" $nti+ireti'7+en)r)ndem$m: e'it$r 5,1!et r$dio&r$+!% )nt)' men&indi'$i'$n $d$n%$ +ne)moniti,9,Pemeri'$$n !ito+$to(o&i d$n imono!ito'imi$ d$+$t mend)')n& dite&$''$nn%$ di$&no$,3,Te ($in%$ .Bio+i ')(it mem+er(i!$t'$n ()'$ )+eriderm$Ad$n%$ mi'roi e( e+idermi In-i(tr$i (im+oit +$d$ d$er$! -eri-$')($tor2.-. Penatalaksanaan K!))n%$%$n&di'et$!)i men%e#$#'$nre$'i SJS" e()r)!+en&o#$t$n!$r) di!enti'$n,Pen$t$($'$n$$n$*$(n%$ $m$ den&$n+en$n&$n$n +$ienden&$n ()'$ #$'$r" d$n+er$*$t$n($n/)t$n d$+$t #er)+$ )+orti- 7mi$('$n 6$ir$n intr$ven$: d$n im+tom$ti' 7mi$('$n $n$(&ei'" d((:"tid$' $d$ +en&o#$t$n %$n& +ei-i' )nt)' +en%$'it ini,Kom+re $(ine $t$) B)ro* o()tion )nt)' men)t)+i ()'$ ')(it %$n&ter'e()+$@ter#)'$,A(tern$ti- ($inn%$)nt)'')(it $d$($!+en&&)n$$n6$($mine (otion,Pen&o#$t$nden&$n 'orti'oteroid m$i! 'ontroveri$( emen/$' !$( it) d$+$t men%e#$#'$n +er#)r)'$n 'ondiid$n+enin&'$t$nrei'o)nt)'ter'en$in-e'i e')nder, F$t ($inn%$%$n&di&)n$'$n" $nt$r$($ini'(o-o-$mid d$n i'(o+orin" n$m)n tid$' $d$ %$n& #er!$i(,Pem#eri$n imm)no&(o#)(in intr$ven$ men)n/)''$n )$t) !$( %$n& men/$n/i'$n d$($mmen&)r$n&i d)r$i re$'i $(er&i d$nmem+er#$i'i &e/$($, Pen&o#$t$n)+orti- ($indi$nt$r$n%$+en&&)n$$n $netei n%eri to+i'$( d$n $ntie+ti6" %$n& d$+$t men/$&$ (in&')n&$n tet$+ !$n&$t" d$n+en&&)n$$n $n$(&ei6 intr$ven$, Seor$n& o-t$(mo(o&i $t$) o+tometri !$r) di'on)(t$i'$ne6e+$tn%$"O(e!'$ren$SJSerin&men%e#$#'$n+em#ent)'$n/$rin&$n+$r)tdi d$($m#o($m$t$%$n&'em)di$nmen%e#$#'$nv$')($ri$i 'orne$d$nter&$n&&)n%$+en&(i!$t$n" d$n&$n&&)$nm$t$($inn%$, Di+er()'$n +)($ $d$n%$ +ro&r$m -iioter$+i ete($! +$ien di+er#o(e!'$n +)($n& d$ri r)m$!$'it,2,KortikosteroidBi($ 'e$d$$n )m)m #$i' d$n (ei tid$' men%e()r)! 6)')+ dio#$ti den&$n +rednione 08-58 m&e!$ri,N$m)n#i($'e$d$$n)m)mn%$#)r)'d$n(ei men%e()r)!!$r)dio#$ti e6$r$te+$t d$n6e+$t,Korti'oteroid mer)+$'$n tind$'$n -i(e-$vin& d$n di&)n$'$n de'$met$on intr$ven$ den&$ndoi +erm)($$n 5-= ? < m& e!$ri, Um)mn%$ m$$ 'riti di$t$i d$($m #e#er$+$ !$ri,P$ien teven-Jo!non#er$t!$r)e&er$dir$*$td$ndi#eri'$nde'$met$on=G