{\rtf\ansi\deff0\ansicpg1252

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{\f0\froman times new roman;}{\f1 calibri;}}
{\colortbl\red0\green0\blue0;}
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\cols2\colno1\colw4586\colsr-0\colno2\colw6853\pard\li1226\ri0\sl-213\slmult0 \f
s18\cf0\par\pard\li1226\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1226\ri0\sl-213\
slmult0 \fs18\cf0\par\pard\li1226\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1226\r
i0\sl-213\slmult0 \fs18\cf0\par\pard\li1226\ri0\sl-213\slmult0 \fs18\cf0\par\par
d\li1226\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1226\ri0\sl-213\slmult0 \fs18\c
f0\par\pard\li1226\ri0\sl-373\slmult0 \fs24\cf0\f0\charscalex100\b {1.1}\b0 { }\
fs24\cf0\f0\charscalex100\b {Latar Belakang }\b0 \par\column\pard\li573\ri0\sl-2
13\slmult0 \fs18\cf0\par\pard\li573\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li573\
ri0\sl-213\slmult0 \fs18\cf0\par\pard\li573\ri0\sl-320\slmult0 \fs24\cf0\f0\char
scalex100\b {BAB I }\b0 \par\pard\li0\ri0\sl-400\slmult0 \fs24\cf0\f0\charscalex
100\b {PENDAHULUAN }\b0 \par\pard\sect\sectd\sbknone\pard\li2293\ri0\sl-386\slmu
lt0 \fs24\cf0\f0\charscalex100 {Penyakit darah tinggi atau Hipertensi (Hype
rtension) adalah suatu keadaan di }\par\pard\li1560\ri0\sl-386\slmult0 \fs24
\cf0\f0\charscalex100 {mana seseorang mengalami peningkatan tekanan darah di
atas normal yang ditunjukkan }\par\pard\li1560\ri0\sl-386\slmult0 \fs24\cf0\
f0\charscalex100 {oleh angka systolic (bagian atas) dan angka bawah (dia
stolic) pada pemeriksaan tensi }\par\pard\li1560\ri0\sl-386\slmult0 \fs24\cf0
\f0\charscalex100 {darah menggunakan alat pengukur tekanan darah baik yan
g berupa cuff air raksa }\par\pard\li1560\ri0\sl-386\slmult0 \fs24\cf0\f0\ch
arscalex100 {(sphygmomanometer) ataupun alat digital lainnya. }\par\pard\li2293\
ri0\sl-400\slmult0 \fs22\cf0\f0\charscalex100 {Nilai normal tekanan darah se
seorang dengan ukuran tinggi badan, berat badan, }\par\pard\li1560\ri0\sl386\slmult0 \fs24\cf0\f0\charscalex100 {tingkat aktifitas normal dan kesehat
an secara umum adalah 120/80 mmHG. Dalam }\par\pard\li1560\ri0\sl-386\slmu
lt0 \fs24\cf0\f0\charscalex100 {aktivitas sehari-hari, tekanan darah normaln
ya adalah dengan nilai angka kisaran stabil. }\par\pard\li1560\ri0\sl-386\
slmult0 \fs24\cf0\f0\charscalex100 {Tetapi secara umum, angka pemeriksaan tekana
n darah menurun saat tidur dan meningkat }\par\pard\li1560\ri0\sl-386\slmult0 \f
s24\cf0\f0\charscalex100 {diwaktu beraktifitas atau berolahraga. }\par\pard\li22
93\ri0\sl-386\slmult0 \fs24\cf0\f0\charscalex100 {Bila seseorang mengalami te
kanan darah tinggi dan tidak mendapatkan }\par\pard\li1560\ri0\sl-386\slmul
t0 \fs24\cf0\f0\charscalex100 {pengobatan dan pengontrolan secara teratur (
rutin), maka hal ini dapat membawa si }\par\pard\li1560\ri0\sl-400\slmult0
\fs24\cf0\f0\charscalex100 {penderita kedalam kasus-kasus serius bahkan bisa me
nyebabkan kematian. Tekanan darah }\par\pard\li1560\ri0\sl-386\slmult0 \fs24\cf0
\f0\charscalex100 {tinggi yang terus menerus menyebabkan jantung seseorang bek
erja extra keras, akhirnya }\par\pard\li1560\ri0\sl-386\slmult0 \fs24\cf0\f0\ch
arscalex100 {kondisi ini berakibat terjadinya kerusakan pada pembuluh darah jant
ung, ginjal, otak dan }\par\pard\li1560\ri0\sl-386\slmult0 \fs24\cf0\f0\charscal
ex100 {mata. Penyakit hypertensi ini merupakan penyebab umum terjadinya stroke d
an serangan }\par\pard\li1560\ri0\sl-386\slmult0 \fs24\cf0\f0\charscalex100 {jan
tung (}\fs24\cf0\f0\charscalex100\i {Heart attack}\i0 \fs24\cf0\f0\charscalex100
{) (Anonim, 2009). }\par\pard\li1226\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li12
26\ri0\sl-386\slmult0 \fs24\cf0\f0\charscalex100\b {1.2}\b0 { }\fs24\cf0\f0\char
scalex100\b {Tujuan Penulisan }\b0 \par\pard\li1906\ri0\sl-373\slmult0 \fs24\cf0
\f0\charscalex100 {Tujuan dari penulisan makalah ini adalah untuk mempela
jari bagaimana cara }\par\pard\li1560\ri0\sl-386\slmult0 \fs24\cf0\f0\charscal
ex100 {penanganan kasus dalam suatu resep dengan menerapkan cara berkomu
nikasi, }\par\pard\li1560\ri0\sl-386\slmult0 \fs24\cf0\f0\charscalex100 {memberi
kan informasi dan edukasi. }\par\pard\sect\sectd\sbknone\pard\sect\sectd\sbkpage
\pgwsxn12240\pghsxn15840\marglsxn666\margrsxn133\margtsxn666\margbsxn546\cols2\c
olno1\colw4773\colsr-0\colno2\colw6666\pard\li1226\ri0\sl-213\slmult0 \fs18\cf0\
par\pard\li1226\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1226\ri0\sl-213\slmult0
\fs18\cf0\par\pard\li1226\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1226\ri0\sl-21

3\slmult0 \fs18\cf0\par\pard\li1226\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1226

\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1226\ri0\sl-213\slmult0 \fs18\cf0\par\p
ard\li1226\ri0\sl-373\slmult0 \fs24\cf0\f0\charscalex100\b {2.1}\b0 { }\fs22\cf0
\f0\charscalex100\b {Pengertian Hipertensi}\b0 \par\column\pard\li346\ri0\sl-213
\slmult0 \fs18\cf0\par\pard\li346\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li346\ri
0\sl-213\slmult0 \fs18\cf0\par\pard\li346\ri0\sl-320\slmult0 \fs24\cf0\f0\charsc
alex100\b {BAB II }\b0 \par\pard\li0\ri0\sl-400\slmult0 \fs24\cf0\f0\charscalex1
00\b {HIPERTENSI}\b0 \par\pard\sect\sectd\sbknone\pgwsxn12240\pghsxn15840\margls
xn666\margrsxn133\pard\li2293\ri0\sl-386\slmult0 \fs24\cf0\f0\charscalex100 {Tek
anan darah tinggi atau hipertensi adalah kondisi medis di mana terjadi }\pa
r\pard\li1626\ri0\sl-386\slmult0 \fs24\cf0\f0\charscalex100 {peningkatan tekanan
darah secara kronis (dalam jangka waktu lama). Penderita yang }\par\par
d\li1626\ri0\sl-386\slmult0 \fs22\cf0\f0\charscalex100 {mempunyai sekurang-kuran
gnya tiga bacaan tekanan darah yang melebihi 140/90 mmHg }\par\pard\li1626\ri0\s
l-386\slmult0 \fs24\cf0\f0\charscalex100 {saat istirahat diperkirakan mempuny
ai keadaan darah tinggi. Tekanan darah yang selalu }\par\pard\li1626\ri0\sl386\slmult0 \fs24\cf0\f0\charscalex100 {tinggi adalah salah satu faktor ris
iko untuk stroke, serangan jantung, gagal }\par\pard\li1626\ri0\sl-400\slmult0
\fs24\cf0\f0\charscalex100 {jantung dan aneurisma arterial, dan merupakan penye
bab utama gagal jantung kronis. }\par\pard\li2306\ri0\sl-386\slmult0 \fs24\cf0\f
0\charscalex100 {Pada pemeriksaan tekanan darah akan didapat dua angka.
Angka yang lebih }\par\pard\li1626\ri0\sl-386\slmult0 \fs24\cf0\f0\charscalex1
00 {tinggi diperoleh pada saat jantung berkontraksi (}\fs24\cf0\f0\charsca
lex100\i {sis}\i0 \fs24\cf0\f0\charscalex100\i {tol}\i0 \fs24\cf0\f0\charscalex1
00\i {i}\i0 \fs24\cf0\f0\charscalex100\i {k}\i0 \fs24\cf0\f0\charscalex100 {),
angka yang lebih rendah }\par\pard\li1626\ri0\sl-386\slmult0 \fs24\cf0\f0\cha
rscalex100 {diperoleh pada saat jantung berelaksasi (}\fs24\cf0\f0\charscal
ex100\i {d}\i0 \fs24\cf0\f0\charscalex100\i {i}\i0 \fs24\cf0\f0\charscalex100\i
{a}\i0 \fs24\cf0\f0\charscalex100\i {s}\i0 \fs24\cf0\f0\charscalex100\i {tol}\i0
\fs24\cf0\f0\charscalex100\i {i}\i0 \fs24\cf0\f0\charscalex100\i {k}\i0 \fs24\c
f0\f0\charscalex100 {). Tekanan darah kurang dari 120/80 }\par\pard\li1626\
ri0\sl-386\slmult0 \fs22\cf0\f0\charscalex100 {mmHg didefinisikan sebagai "no
rmal". Pada tekanan darah tinggi, biasanya terjadi }\par\pard\li1626\ri0\s
l-386\slmult0 \fs24\cf0\f0\charscalex100 {kenaikan tekanan sistolik dan dias
tolik. Hipertensi biasanya terjadi pada tekanan }\par\pard\li1626\ri0\sl-386
\slmult0 \fs24\cf0\f0\charscalex100 {darah 140/90 mmHg atau ke atas, diukur
di kedua lengan tiga kali dalam jangka }\par\pard\li1626\ri0\sl-400\slmu
lt0 \fs24\cf0\f0\charscalex100 {beberapa minggu }\par\pard\li2293\ri0\sl-386\slm
ult0 \fs22\cf0\f0\charscalex100 {Pada sebagian besar penderita, hipertensi
tidak menimbulkan gejala; meskipun }\par\pard\li1626\ri0\sl-386\slmult0 \fs24
\cf0\f0\charscalex100 {secara tidak sengaja beberapa gejala terjadi bersam
aan dan dipercaya berhubungan }\par\pard\li1626\ri0\sl-386\slmult0 \fs22\cf0\
f0\charscalex100 {dengan tekanan darah tinggi (padahal sesungguhnya tidak). Geja
la yang dimaksud adalah }\par\pard\li1626\ri0\sl-400\slmult0 \fs24\cf0\f0\charsc
alex100 {sakit kepala, perdarahan dari hidung, pusing, wajah kemerahan dan kelel
ahan; yang bisa }\par\pard\li1626\ri0\sl-386\slmult0 \fs22\cf0\f0\charscalex100
{saja terjadi baik pada penderita hipertensi, maupun pada seseorang dengan tekan
an darah }\par\pard\li1626\ri0\sl-386\slmult0 \fs24\cf0\f0\charscalex100 {yang n
ormal. }\par\pard\li1626\ri0\sl-386\slmult0 \fs24\cf0\f0\charscalex100 {Jika hip
ertensinya berat atau menahun dan tidak diobati, bisa timbul gejala berikut: }\p
ar\pard\li1906\ri0\sl-386\slmult0 \fs24\cf0\f0\charscalex100 {sakit kepala }\par
\pard\li1906\ri0\sl-386\slmult0 \fs24\cf0\f0\charscalex100 {kelelahan }\par\pard
\li1906\ri0\sl-400\slmult0 \fs24\cf0\f0\charscalex100 {mual }\par\pard\li1906\ri
0\sl-386\slmult0 \fs24\cf0\f0\charscalex100 {muntah }\par\pard\li1906\ri0\sl-386
\slmult0 \fs24\cf0\f0\charscalex100 {sesak napas }\par\pard\li1906\ri0\sl-386\sl
mult0 \fs24\cf0\f0\charscalex100 {gelisah }\par\pard\li1893\ri0\sl-386\slmult0 \
fs24\cf0\f0\charscalex100 {pandangan menjadi kabur yang terjadi karena ada
nya kerusakan pada otak, mata, }\par\pard\li1893\ri0\sl-386\slmult0 \fs24\cf
0\f0\charscalex100 {jantung dan ginjal. }\par\pard\sect\sectd\sbknone\pgwsxn1224
0\pghsxn15840\marglsxn666\margrsxn133\pard\sect\sectd\sbkpage\pgwsxn12240\pghsxn

15840\marglsxn666\margrsxn133\margtsxn666\margbsxn426\pard\li1626\ri0\sl-213\slm
ult0 \fs18\cf0\par\pard\li1626\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1626\ri0\
sl-213\slmult0 \fs18\cf0\par\pard\li1626\ri0\sl-346\slmult0 \fs24\cf0\f0\charsca
lex100 {K}\fs24\cf0\f0\charscalex100 {adang penderita hipertensi berat menga
lami penurunan kesadaran dan bahkan koma }\par\pard\li1626\ri0\sl-386\slmul
t0 \fs24\cf0\f0\charscalex100 {karena terjadi pembengkakan otak. }{ }\fs24\cf0
\f0\charscalex100 {K}\fs24\cf0\f0\charscalex100 {eadaan ini disebut }\fs24\cf0
\f0\charscalex100\i {en}\i0 \fs24\cf0\f0\charscalex100\i {s}\i0 \fs24\cf0\f0\cha
rscalex100\i {efalopat}\i0 \fs24\cf0\f0\charscalex100\i {i}\i0 \fs24\cf0\f0\char
scalex100\i { h}\i0 \fs24\cf0\f0\charscalex100\i {i}\i0 \fs24\cf0\f0\charscalex
100\i {perten}\i0 \fs24\cf0\f0\charscalex100\i {si}\i0 \fs24\cf0\f0\charscalex10
0\i {f}\i0 \fs24\cf0\f0\charscalex100 {, yang }\par\pard\li1626\ri0\sl-360\slmu
lt0 \fs24\cf0\f0\charscalex100 {memerlukan penanganan segera (Anonim, 2009). }\p
ar\pard\li1226\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1226\ri0\sl-213\slmult0 \
fs18\cf0\par\pard\li1226\ri0\sl-386\slmult0 \fs24\cf0\f0\charscalex100 {2.2 }\fs
24\cf0\f0\charscalex100 {K}\fs24\cf0\f0\charscalex100 {lasifikasi Hipertensi }\p
ar\pard\li1626\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {Penyakit darah t
inggi atau Hipertensi dikenal dengan 2 type klasifikasi, diantaranya }\p
ar\pard\li1626\ri0\sl-400\slmult0 \fs24\cf0\f0\charscalex100 {Hipertensi Primary
dan Hipertensi Secondary : }\par\pard\li1626\ri0\sl-426\slmult0 \*\tx1906\fs24\
cf0\f0\charscalex100 {y}\tab \fs24\cf0\f0\charscalex100 {Hipertensi Primary }\pa
r\pard\li2560\ri0\sl-360\slmult0 \fs24\cf0\f0\charscalex100 {Hipertensi Primary
adalah suatu kondisi dimana terjadinya tekanan darah }\par\pard\li1893\r
i0\sl-400\slmult0 \fs24\cf0\f0\charscalex100 {tinggi sebagai akibat dampak d
ari gaya hidup seseorang dan faktor lingkungan. }\par\pard\li1893\ri0\sl-3
86\slmult0 \fs22\cf0\f0\charscalex100 {Seseorang yang pola makannya tidak t
erkontrol dan mengakibatkan kelebihan berat }\par\pard\li1893\ri0\sl-386\slm
ult0 \fs24\cf0\f0\charscalex100 {badan atau bahkan obesitas, merupakan pencetus
awal untuk terkena penyakit tekanan }\par\pard\li1893\ri0\sl-386\slmult0 \fs24\c
f0\f0\charscalex100 {darah tinggi. Begitu pula sesorang yang berada dalam
lingkungan atau kondisi }\par\pard\li1893\ri0\sl-386\slmult0 \fs24\cf0\f0\ch
arscalex100 {stressor tinggi sangat mungkin terkena penyakit tekanan darah tingg
i, termasuk orang-}\par\pard\li1893\ri0\sl-386\slmult0 \fs24\cf0\f0\charscalex10
0 {orang yang kurang olahraga pun bisa mengalami tekanan darah tinggi. }\par\par
d\li1626\ri0\sl-440\slmult0 \*\tx1906\fs24\cf0\f0\charscalex100 {y}\tab \fs24\cf
0\f0\charscalex100 {Hipertensi Secondary }\par\pard\li1626\ri0\sl-400\slmult0 \*
\tx1906\fs24\cf0\f0\charscalex100 {y}\tab \fs24\cf0\f0\charscalex100 {Hipertensi
secondary adalah suatu kondisi dimana terjadinya peningkatan tekanan }\
par\pard\li1626\ri0\sl-360\slmult0 \fs24\cf0\f0\charscalex100 {darah tinggi se
bagai akibat seseorang mengalami/menderita penyakit lainnya seperti }\par\
pard\li1626\ri0\sl-400\slmult0 \fs24\cf0\f0\charscalex100 {gagal jantung, gaga
l ginjal, atau kerusakan sistem hormon tubuh. Sedangkan pada Ibu }\par\pa
rd\li1626\ri0\sl-386\slmult0 \fs24\cf0\f0\charscalex100 {hamil, tekanan darah
secara umum meningkat saat kehamilan berusia 20 minggu. }\par\pard\li162
6\ri0\sl-386\slmult0 \fs24\cf0\f0\charscalex100 {Terutama pada wanita yang b
erat badannya di atas normal atau gemuk (gendut). }\par\pard\li1626\ri0\s
l-386\slmult0 \fs24\cf0\f0\charscalex100 {Pregnancy-induced hypertension (PIH)
, ini adalah sebutan dalam istilah kesehatan }\par\pard\li1626\ri0\sl-426\
slmult0 \fs24\cf0\f0\charscalex100 {(medis) bagi wanita hamil yang menderita hip
ertensi. }\fs24\cf0\f0\charscalex100 {K}\fs24\cf0\f0\charscalex100 {ondisi Hiper
tensi pada ibu hamil }\par\pard\li1626\ri0\sl-346\slmult0 \fs24\cf0\f0\charscale
x100 {bisa sedang ataupun tergolang parah/berbahaya, Seorang ibu hamil dengan te
kanan darah }\par\pard\li1626\ri0\sl-400\slmult0 \fs24\cf0\f0\charscalex100 {tin
ggi bisa mengalami Preeclampsia dimasa kehamilannya itu. Preeclampsia ad
alah }\par\pard\li1626\ri0\sl-386\slmult0 \fs22\cf0\f0\charscalex100 {kondisi s
eorang wanita hamil yang mengalami hipertensi, sehingga merasakan keluha
n }\par\pard\li1626\ri0\sl-386\slmult0 \fs24\cf0\f0\charscalex100 {seperti pusin
g, sakit kepala, gangguan penglihatan, nyeri perut, muka yang membengkak, }\par\
pard\li1626\ri0\sl-386\slmult0 \fs24\cf0\f0\charscalex100 {kurang nafsu makan,
mual bahkan muntah. Apabila terjadi kekejangan sebagai dampak }\par\pard

\li1626\ri0\sl-386\slmult0 \fs24\cf0\f0\charscalex100 {hipertensi maka disebut E

clamsia. }\par\pard\li1226\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1226\ri0\sl-2
13\slmult0 \fs18\cf0\par\pard\li1226\ri0\sl-360\slmult0 \fs24\cf0\f0\charscalex1
00 {2.3 Penyebab Hipertensi }\par\pard\li2426\ri0\sl-386\slmult0 \fs24\cf0\f0\ch
arscalex100 {Penggunaan obat-obatan seperti golongan kortikosteroid (cortis
on) dan }\par\pard\li1626\ri0\sl-386\slmult0 \fs24\cf0\f0\charscalex100 {bebera
pa obat hormon, termasuk beberapa obat antiradang (anti-inflammasi) secara terus
}\par\pard\sect\sectd\sbkpage\pgwsxn12240\pghsxn15840\marglsxn666\margrsxn133\m
argtsxn666\margbsxn333\pard\li1626\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1626\
ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1626\ri0\sl-213\slmult0 \fs18\cf0\par\pa
rd\li1626\ri0\sl-320\slmult0 \fs24\cf0\f0\charscalex100 {menerus (sering) dapa
t meningkatkan tekanan darah seseorang. Merokok juga }\par\pard\li1626\ri0
\sl-386\slmult0 \fs22\cf0\f0\charscalex100 {merupakan salah satu faktor peny
ebab terjadinya peningkatan tekanan darah tinggi }\par\pard\li1626\ri0\sl-3
86\slmult0 \fs22\cf0\f0\charscalex100 {dikarenakan tembakau yang berisi niko
tin. Minuman yang mengandung alkohol juga }\par\pard\li1626\ri0\sl-386\slmu
lt0 \fs24\cf0\f0\charscalex100 {termasuk salah satu faktor yang dapat meni
mbulkan terjadinya tekanan darah tinggi }\par\pard\li1626\ri0\sl-386\slmult0
\fs24\cf0\f0\charscalex100 {(Wikipedia, 2010). }\par\pard\li1226\ri0\sl-213\slm
ult0 \fs18\cf0\par\pard\li1226\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1226\ri0\
sl-360\slmult0 \fs24\cf0\f0\charscalex100 {2.3 Penanganan dan Pengobatan Hiperte
nsi }\par\pard\li1653\ri0\sl-386\slmult0 \fs24\cf0\f0\charscalex100 {a. Diet Pen
yakit Darah Tinggi (Hipertensi) }\par\pard\li1960\ri0\sl-426\slmult0 \*\tx2293\f
s20\cf0\f0\charscalex100 {y}\tab \fs24\cf0\f0\charscalex100 {K}\fs24\cf0\f0\char
scalex100 {andungan garam (Sodium/Natrium) }\par\pard\li2293\ri0\sl-346\slmult0
\fs24\cf0\f0\charscalex100 {Seseorang yang mengidap penyakit darah tinggi sebaik
nya mengontrol diri dalam }\par\pard\li2293\ri0\sl-386\slmult0 \fs22\cf0\f0\char
scalex100 {mengkonsumsi asin-asinan garam, ada beberapa tips yang bisa d
ilakukan untuk }\par\pard\li2293\ri0\sl-400\slmult0 \fs24\cf0\f0\charscalex100
{pengontrolan diet sodium/natrium ini ; }\par\pard\li2213\ri0\sl-386\slmult0 \*\
tx2560\fs24\cf0\f0\charscalex100 {1.}\tab \fs24\cf0\f0\charscalex100 {Jangan mel
etakkan garam diatas meja makan }\par\pard\li2213\ri0\sl-386\slmult0 \*\tx2560\f
s24\cf0\f0\charscalex100 {2.}\tab \fs24\cf0\f0\charscalex100 {Pilih jumlah kandu
ngan sodium rendah saat membeli makan }\par\pard\li2213\ri0\sl-386\slmult0 \*\tx
2560\fs24\cf0\f0\charscalex100 {3.}\tab \fs24\cf0\f0\charscalex100 {Batasi konsu
msi daging dan keju }\par\pard\li2213\ri0\sl-386\slmult0 \*\tx2560\fs24\cf0\f0\c
harscalex100 {4.}\tab \fs24\cf0\f0\charscalex100 {Hindari cemilan yang asin-asin
}\par\pard\li2213\ri0\sl-426\slmult0 \*\tx2613\fs24\cf0\f0\charscalex100 {5.}\t
ab \fs24\cf0\f0\charscalex100 {K}\fs24\cf0\f0\charscalex100 {urangi pemakaian sa
os yang umumnya memiliki kandungan sodium }\par\pard\li1960\ri0\sl-386\slmult0 \
*\tx2293\fs20\cf0\f0\charscalex100 {y}\tab \fs24\cf0\f0\charscalex100 {K}\fs24\c
f0\f0\charscalex100 {andungan Potasium/}\fs24\cf0\f0\charscalex100 {K}\fs24\cf0\
f0\charscalex100 {alium }\par\pard\li2293\ri0\sl-360\slmult0 \fs24\cf0\f0\charsc
alex100 {Suplements potasium 2-4 gram perhari dapat membantu penurunan t
ekanan }\par\pard\li2293\ri0\sl-386\slmult0 \fs24\cf0\f0\charscalex100 {darah,
Potasium umumnya bayak didapati pada beberapa buah-buahan dan }\par\pard\
li2293\ri0\sl-386\slmult0 \fs24\cf0\f0\charscalex100 {sayuran. Buah dan sayur
an yang mengandung potasium dan baik untuk di }\par\pard\li2293\ri0\sl-38
6\slmult0 \fs22\cf0\f0\charscalex100 {konsumsi penderita tekanan darah tingg
i antara lain semangka, alpukat, melon, }\par\pard\li2293\ri0\sl-400\slmult
0 \fs24\cf0\f0\charscalex100 {buah pare, labu siam, bligo, labu parang/lab
u, mentimun, lidah buaya, seledri, }\par\pard\li2293\ri0\sl-386\slmult0 \fs2
4\cf0\f0\charscalex100 {bawang dan bawang putih. Selain itu, makanan yang mengan
dung unsur omega-3 }\par\pard\li2293\ri0\sl-386\slmult0 \fs24\cf0\f0\charscalex1
00 {sagat dikenal efektif dalam membantu penurunan tekanan darah (hipertensi). }
\par\pard\li2693\ri0\sl-386\slmult0 \fs24\cf0\f0\charscalex100 {Pengobatan hipe
rtensi biasanya dikombinasikan dengan beberapa obat; }\par\pard\li2693\ri0\
sl-386\slmult0 \fs22\cf0\f0\charscalex100 {Diuretic \{Tablet Hydrochlorothiazi
de (HCT), Lasix (Furosemide)\}. }\par\pard\li2693\ri0\sl-400\slmult0 \fs24\cf
0\f0\charscalex100 {Merupakan golongan obat hipertensi dengan proses pengeluaran

cairan tubuh }\par\pard\li2693\ri0\sl-386\slmult0 \fs22\cf0\f0\charscalex100 {v

ia urine. Tetapi karena potasium berkemungkinan terbuang dalam cairan }\
par\pard\li2693\ri0\sl-386\slmult0 \fs24\cf0\f0\charscalex100 {urine, maka pengo
ntrolan konsumsi potasium harus dilakukan. }\par\pard\li2693\ri0\sl-386\slmult0
\fs20\cf0\f0\charscalex100 {Beta-blockers \{Atenolol (Tenorim), Capoten (Cap
topril)\}. Merupakan obat }\par\pard\li2693\ri0\sl-386\slmult0 \fs24\cf0\f0\ch
arscalex100 {yang dipakai dalam upaya pengontrolan tekanan darah melalui
proses }\par\pard\li2693\ri0\sl-400\slmult0 \fs24\cf0\f0\charscalex100 {memperl
ambat kerja jantung dan memperlebar (vasodilatasi) pembuluh }\par\pard\li2
693\ri0\sl-386\slmult0 \fs24\cf0\f0\charscalex100 {darah. }\par\pard\sect\sectd\
sbkpage\pgwsxn12240\pghsxn15840\marglsxn666\margrsxn133\margtsxn666\margbsxn493\
pard\li2693\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2693\ri0\sl-213\slmult0 \fs1
8\cf0\par\pard\li2693\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2693\ri0\sl-320\sl
mult0 \fs24\cf0\f0\charscalex100 {Calcium channel blockers \{Norvasc (amlopi
dine), Angiotensinconverting }\par\pard\li2693\ri0\sl-386\slmult0 \fs24\cf0\f0\
charscalex100 {enzyme (ACE)\}. Merupakan salah satu obat yang biasa dipa
kai dalam }\par\pard\li2693\ri0\sl-386\slmult0 \fs24\cf0\f0\charscalex100 {peng
ontrolan darah tinggi atau Hipertensi melalui proses rileksasi pembuluh }\par\p
ard\li2693\ri0\sl-386\slmult0 \fs24\cf0\f0\charscalex100 {darah yang juga memper
lebar pembuluh darah (Wikipedia, 2010). }\par\pard\li1226\ri0\sl-213\slmult0 \fs
18\cf0\par\pard\li1226\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1226\ri0\sl-346\s
lmult0 \fs24\cf0\f0\charscalex100 {2.4 Hipertensi Pada Ibu Hamil }\par\pard\li22
93\ri0\sl-400\slmult0 \fs24\cf0\f0\charscalex100 {Hipertensi merupakan salah
satu masalah medis yang kerapkali muncul selama }\par\pard\li1626\ri0\sl-3
86\slmult0 \fs24\cf0\f0\charscalex100 {kehamilan dan dapat menimbulkan kompl
ikasi pada 2-3 persen kehamilan. Hipertensi }\par\pard\li1626\ri0\sl-386\sl
mult0 \fs24\cf0\f0\charscalex100 {pada kehamilan dapat menyebabkan morbidita
s/ kesakitan pada ibu (termasuk kejang }\par\pard\li1626\ri0\sl-386\slmult0
\fs24\cf0\f0\charscalex100 {eklamsia, perdarahan otak, edema paru (cairan
di dalam paru), gagal ginjal akut, dan }\par\pard\li1626\ri0\sl-386\slmult
0 \fs24\cf0\f0\charscalex100 {penggumpalan/ pengentalan darah di dalam pembuluh
darah) serta morbiditas pada janin }\par\pard\li1626\ri0\sl-400\slmult0 \fs24\cf
0\f0\charscalex100 {(termasuk pertumbuhan janin terhambat di dalam rahim, kemati
an janin di dalam rahim, }\par\pard\li1626\ri0\sl-386\slmult0 \fs24\cf0\f0\chars
calex100 {solusio plasenta/ plasenta terlepas dari tempat melekatnya di
rahim, dan kelahiran }\par\pard\li1626\ri0\sl-386\slmult0 \fs24\cf0\f0\charsca
lex100 {prematur). Selain itu, hipertensi pada kehamilan juga masih merup
akan sumber utama }\par\pard\li1626\ri0\sl-386\slmult0 \fs24\cf0\f0\charscalex
100 {penyebab kematian pada ibu. }\par\pard\li1560\ri0\sl-213\slmult0 \fs18\cf0\
par\pard\li1560\ri0\sl-293\slmult0 \fs24\cf0\f0\charscalex100 {Hipertensi pada k
ehamilan dapat diklasifikasikan dalam 4 kategori, yaitu: }\par\pard\li1560\ri0\s
l-213\slmult0 \fs18\cf0\par\pard\li1560\ri0\sl-293\slmult0 \*\tx1906\fs24\cf0\f0
\charscalex100 {1.}\tab \fs24\cf0\f0\charscalex100 {Hipertensi kronik: hiperte
nsi (tekanan darah lebih dari 140/90 mmHg yang diukur }\par\pard\li1906\
ri0\sl-386\slmult0 \fs24\cf0\f0\charscalex100 {setelah beristirahat selama 510 menit dalam posisi duduk) yang telah didiagnosis }\par\pard\li1906\ri0
\sl-386\slmult0 \fs24\cf0\f0\charscalex100 {sebelum kehamilan terjadi atau h
ipertensi yang timbul sebelum mencapai usia }\par\pard\li1906\ri0\sl-386\sl
mult0 \fs24\cf0\f0\charscalex100 {kehamilan 20 minggu. }\par\pard\li1560\ri0\sl213\slmult0 \fs18\cf0\par\pard\li1560\ri0\sl-293\slmult0 \*\tx1906\fs24\cf0\f0\c
harscalex100 {2.}\tab \fs24\cf0\f0\charscalex100 {Preeklamsia-Eklamsia: peningk
atan tekanan darah yang baru timbul setelah usia }\par\pard\li1906\ri0\sl
-386\slmult0 \fs24\cf0\f0\charscalex100 {kehamilan mencapai 20 minggu, diser
tai dengan penambahan berat badan ibu yang }\par\pard\li1906\ri0\sl-386\sl
mult0 \fs24\cf0\f0\charscalex100 {cepat akibat tubuh membengkak dan pada pemerik
saan laboratorium dijumpai protein }\par\pard\li1906\ri0\sl-386\slmult0 \fs24\cf
0\f0\charscalex100 {di dalam air seni (proteinuria). Eklamsia: preeklamsia yang
disertai dengan kejang. }\par\pard\li1560\ri0\sl-213\slmult0 \fs18\cf0\par\pard\
li1560\ri0\sl-293\slmult0 \*\tx1906\fs24\cf0\f0\charscalex100 {3.}\tab \fs24\cf0
\f0\charscalex100 {Preeklamsia }\fs24\cf0\f0\charscalex100\i {su}\i0 \fs24\cf0\f

0\charscalex100\i {per}\i0 \fs24\cf0\f0\charscalex100\i {im}\i0 \fs24\cf0\f0\cha

rscalex100\i {po}\i0 \fs24\cf0\f0\charscalex100\i {s}\i0 \fs24\cf0\f0\charscalex
100\i {ed}\i0 \fs24\cf0\f0\charscalex100 { pada hipertensi kronik: preeklamsi
a yang terjadi pada }\par\pard\li1906\ri0\sl-386\slmult0 \fs24\cf0\f0\charsca
lex100 {perempuan hamil yang telah menderita hipertensi sebelum hamil. }\par\par
d\li1560\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1560\ri0\sl-293\slmult0 \*\tx19
06\fs24\cf0\f0\charscalex100 {4.}\tab \fs22\cf0\f0\charscalex100 {Hipertensi ge
stasional: hipertensi pada kehamilan yang timbul pada trimester akhir }\
par\pard\li1906\ri0\sl-386\slmult0 \fs24\cf0\f0\charscalex100 {kehamilan, namun
tanpa disertai gejala dan tanda preeklamsia, bersifat sementara dan }\par\pard\l
i1906\ri0\sl-386\slmult0 \fs24\cf0\f0\charscalex100 {tekanan darah kembali no
rmal setelah melahirkan (postpartum). Hipertensi }\par\pard\li1906\ri0\sl-386
\slmult0 \fs24\cf0\f0\charscalex100 {gestasional berkaitan dengan timbulnya
hipertensi kronik suatu saat di masa yang }\par\pard\li1906\ri0\sl-386\slm
ult0 \fs24\cf0\f0\charscalex100 {akan datang. }\par\pard\sect\sectd\sbkpage\pgws
xn12240\pghsxn15840\marglsxn666\margrsxn133\margtsxn666\margbsxn346\pard\li2293\
ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2293\ri0\sl-213\slmult0 \fs18\cf0\par\pa
rd\li2293\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2293\ri0\sl-320\slmult0 \fs24\
cf0\f0\charscalex100 {Preeklamsia terjadi pada kurang lebih 5% dari selur
uh kehamilan, 10% pada }\par\pard\li1626\ri0\sl-386\slmult0 \fs22\cf0\f0\char
scalex100 {kehamilan anak pertama, dan 20-25% pada perempuan hamil dengan riway
at hipertensi }\par\pard\li1626\ri0\sl-386\slmult0 \fs24\cf0\f0\charscalex100 {k
ronik sebelum hamil. Faktor risiko ibu untuk terjadinya preeklamsia antara lain
meliputi }\par\pard\li1626\ri0\sl-386\slmult0 \fs24\cf0\f0\charscalex100 {kehami
lan pertama, pasangan/ paternitas baru, usia lebih muda dari 18 tahun atau
lebih }\par\pard\li1626\ri0\sl-386\slmult0 \fs22\cf0\f0\charscalex100 {tua dar
i 35 tahun, riwayat preeklamsia pada kehamilan sebelumnya, riwayat kelu
arga }\par\pard\li1626\ri0\sl-386\slmult0 \fs24\cf0\f0\charscalex100 {dengan pr
eeklamsia, obesitas/ kegemukan, dan selang waktu jarak antar kehamilan }
\par\pard\li1626\ri0\sl-400\slmult0 \fs24\cf0\f0\charscalex100 {kurang dari 2 ta
hun atau lebih dari 10 tahun. }\par\pard\li2293\ri0\sl-213\slmult0 \fs18\cf0\par
\pard\li2293\ri0\sl-280\slmult0 \fs24\cf0\f0\charscalex100 {Dasar penyebab pre
eklamsia diduga adalah gangguan pada fungsi endotel }\par\pard\li1626\ri0\
sl-400\slmult0 \fs24\cf0\f0\charscalex100 {pembuluh darah (sel pelapis bagia
n dalam pembuluh darah) yang menimbulkan }\par\pard\li1626\ri0\sl-386\slmul
t0 \fs24\cf0\f0\charscalex100 {vasospasme pembuluh darah (kontraksi otot pe
mbuluh darah yang menyebabkan }\par\pard\li1626\ri0\sl-386\slmult0 \fs24\cf0\
f0\charscalex100 {diameter lumen pembuluh darah mengecil/ menciut). Peruba
han respons imun ibu }\par\pard\li1626\ri0\sl-386\slmult0 \fs24\cf0\f0\charsc
alex100 {terhadap janin/ jaringan plasenta (ari-ari) diduga juga berperan
pada terjadinya }\par\pard\li1626\ri0\sl-426\slmult0 \fs24\cf0\f0\charscalex1
00 {preeklamsia. }\fs24\cf0\f0\charscalex100 {K}\fs24\cf0\f0\charscalex100 {erus
akan endotel tidak hanya menimbulkan mikrotrombosis difus plasenta }\par\pard\li
1626\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {(sumbatan pembuluh darah pla
senta) yang menyebabkan plasenta berkembang abnormal }\par\pard\li1626\ri0\sl-40
0\slmult0 \fs24\cf0\f0\charscalex100 {atau rusak, tapi juga menimbulkan gangguan
fungsi berbagai organ tubuh dan kebocoran }\par\pard\li1626\ri0\sl-386\slmult0
\fs24\cf0\f0\charscalex100 {pembuluh darah kapiler yang bermanifestasi pada ibu
dengan bertambahnya berat badan }\par\pard\li1626\ri0\sl-386\slmult0 \fs24\cf0\f
0\charscalex100 {ibu secara cepat, bengkak (perburukan mendadak bengkak pada ked
ua tungkai, bengkak }\par\pard\li1626\ri0\sl-386\slmult0 \fs24\cf0\f0\charscalex
100 {pada tangan dan wajah), edema paru, dan/ atau hemokonsentrasi (kadar hemogl
obin/ Hb }\par\pard\li1626\ri0\sl-386\slmult0 \fs24\cf0\f0\charscalex100 {lebih
dari 13 g/dL). Plasenta yang tidak normal akibat mikrotrombosis difus,
akan }\par\pard\li1626\ri0\sl-400\slmult0 \fs24\cf0\f0\charscalex100 {menurunk
an aliran darah dari rahim ke plasenta. Hal tersebut akan memengaruhi
}\par\pard\li1626\ri0\sl-386\slmult0 \fs24\cf0\f0\charscalex100 {kehidupan jani
n dan bermanifestasi secara klinis dalam bentuk pertumbuhan janin }\par\
pard\li1626\ri0\sl-386\slmult0 \fs24\cf0\f0\charscalex100 {terhambat di dalam ka
ndungan/ rahim dan oligohidramnion (cairan ketuban sedikit). }\par\pard\li2293\

ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2293\ri0\sl-280\slmult0 \fs20\cf0\f0\cha

rscalex100 {Berdasarkan hal-hal yang telah dijelaskan di dalam tulisan d
i atas, pemeriksaan }\par\pard\li1626\ri0\sl-400\slmult0 \fs24\cf0\f0\charscal
ex100 {kehamilan secara berkala sangat penting pada semua ibu hamil untuk mendet
eksi adanya }\par\pard\li1626\ri0\sl-386\slmult0 \fs24\cf0\f0\charscalex100 {hip
ertensi pada kehamilan sehingga dapat diberikan tatalaksana yang tepat. Lebih la
njut, }\par\pard\li1626\ri0\sl-386\slmult0 \fs22\cf0\f0\charscalex100 {perempuan
yang menderita hipertensi pada kehamilan memerlukan tindak lanjut medi
s }\par\pard\li1626\ri0\sl-386\slmult0 \fs24\cf0\f0\charscalex100 {atau dimonito
r kondisi medisnya setelah melahirkan. }\par\pard\li2293\ri0\sl-213\slmult0 \fs1
8\cf0\par\pard\li2293\ri0\sl-293\slmult0 \fs22\cf0\f0\charscalex100 {Hipertensi
atau tinggi nya tekanan darah yang terjadi pada masa kehamilan bisa }\par
\pard\li1626\ri0\sl-386\slmult0 \fs24\cf0\f0\charscalex100 {membahayakan kesehat
an ibu dan janin yang dikandungnya. Hipertensi biasanya terjadi }\par\pard\li162
6\ri0\sl-386\slmult0 \fs24\cf0\f0\charscalex100 {pada kehamilan pertama, keha
milan dibawah usia 20 tahun dan diatas 40 tahun, pada }\par\pard\li1626
\ri0\sl-386\slmult0 \fs24\cf0\f0\charscalex100 {wanita yang menderita obesita
s, serta janin kembar. Dampak paling berbahaya yang }\par\pard\li1626\ri0
\sl-400\slmult0 \fs22\cf0\f0\charscalex100 {ditimbulkan oleh hipertensi yaitu
preeclampsia, yang bisa mengancam keselamatan ibu }\par\pard\li1626\ri0\s
l-386\slmult0 \fs24\cf0\f0\charscalex100 {dan bayi. }\par\pard\sect\sectd\sbkpag
e\pgwsxn12240\pghsxn15840\marglsxn666\margrsxn133\margtsxn666\margbsxn333\pard\l
i2293\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2293\ri0\sl-213\slmult0 \fs18\cf0\
par\pard\li2293\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2293\ri0\sl-320\slmult0
\fs24\cf0\f0\charscalex100 {Pada beberapa kasus hipertensi dokter kandungan
biasanya menganjurkan }\par\pard\li1626\ri0\sl-386\slmult0 \fs24\cf0\f0\chars
calex100 {pasiennya untuk melakukan bed rest. Sementara bagi wanita hami
l itu sendiri bisa }\par\pard\li1626\ri0\sl-386\slmult0 \fs24\cf0\f0\charscal
ex100 {mengurangi tekanan darahnya dengan cara melakukan diet sehat, yai
tu dengan }\par\pard\li1626\ri0\sl-386\slmult0 \fs24\cf0\f0\charscalex100 {meng
konsumsi makanan yang bisa menurunkan tekanan darah mereka, diantaranya: }\par\p
ard\li1906\ri0\sl-386\slmult0 \fs24\cf0\f0\charscalex100 {Coklat }\par\pard\li19
06\ri0\sl-386\slmult0 \fs24\cf0\f0\charscalex100 {Siapa yang tak suka coklat, su
dah sejak dahulu kala, coklat menjadi makanan favorit }\par\pard\li1906\ri0\sl
-400\slmult0 \fs24\cf0\f0\charscalex100 {hampir semua orang diseluruh dunia,
terutama wanita. Selain rasanya yang nikmat, }\par\pard\li1906\ri0\sl-386\
slmult0 \fs24\cf0\f0\charscalex100 {jika dikonsumsi dalam porsi kecil, coklat da
pat berguna sebagai magnesium yang bisa }\par\pard\li1906\ri0\sl-386\slmult0 \fs
24\cf0\f0\charscalex100 {melancarkan aliran darah dan menurunkan tekanan d
arah. Jika anda takut lemak }\par\pard\li1906\ri0\sl-386\slmult0 \fs24\cf0\f
0\charscalex100 {coklat membuat anda gemuk, anda bisa mencari alternatif
makanan lain yang juga }\par\pard\li1906\ri0\sl-386\slmult0 \fs24\cf0\f0\cha
rscalex100 {mengandung magnesium diantaranya: Bayam, almon, alpukat, ikan,
gandum, ketan }\par\pard\li1906\ri0\sl-400\slmult0 \fs24\cf0\f0\charscalex100
{hitam, artichoke(sejenis sayuran),dan biji buah labu. }\par\pard\li1906\ri0\sl
-386\slmult0 \fs24\cf0\f0\charscalex100 {Pisang }\par\pard\li1906\ri0\sl-386\slm
ult0 \fs24\cf0\f0\charscalex100 {Pisang merupakan sumber zat potasium yang
dapat membantu menurunkan tekanan }\par\pard\li1906\ri0\sl-386\slmult0 \fs24
\cf0\f0\charscalex100 {darah dan mengurangi pembekuan cairan dalam tubuh.
selain pada buah pisang }\par\pard\li1906\ri0\sl-386\slmult0 \fs22\cf0\f0\ch
arscalex100 {potasium juga bisa ditemui pada kismis, bayam, yogurt, bit,
Brussels sprout(sejenis }\par\pard\li1906\ri0\sl-400\slmult0 \fs24\cf0\f0\cha
rscalex100 {kubis), alpukat, dan jeruk. }\par\pard\li1906\ri0\sl-386\slmult0 \fs
24\cf0\f0\charscalex100 {Ikan }\par\pard\li1906\ri0\sl-413\slmult0 \fs24\cf0\f0\
charscalex100 {K}\fs24\cf0\f0\charscalex100 {andungan asam lemak omega 3 da
lam ikan dapat membantu melancarkan aliran }\par\pard\li1906\ri0\sl-360\slm
ult0 \fs24\cf0\f0\charscalex100 {darah dan melindungi dari efek tekanan da
rah tinggi serta mengurangi peradangan. }\par\pard\li1906\ri0\sl-386\slmult0
\fs24\cf0\f0\charscalex100 {Saat mengkonsumsi ikan hindari jenis ikan yan
g mengandung kadar merkuri tinggi }\par\pard\li1906\ri0\sl-386\slmult0 \fs24

\cf0\f0\charscalex100 {seperti tuna,swordfish(ikan cucut), makarel, ikan ha

libut, serta kakap putih. }\par\pard\li1906\ri0\sl-400\slmult0 \fs24\cf0\f0\c
harscalex100 {Sebaliknya pilihlah ikan yang mengandung kadar mercuri rend
ah seperti ikan }\par\pard\li1906\ri0\sl-386\slmult0 \fs24\cf0\f0\charscalex10
0 {anchovies, ikan char, ikan flounder, ikan harring, ikan gindara, ikan salmon,
dan ikan }\par\pard\li1906\ri0\sl-386\slmult0 \fs24\cf0\f0\charscalex100 {sturg
eon. }\par\pard\li1906\ri0\sl-386\slmult0 \fs24\cf0\f0\charscalex100 {Buah Jeruk
}\par\pard\li1906\ri0\sl-386\slmult0 \fs24\cf0\f0\charscalex100 {Vitamin C sa
ngat bermanfaat untuk melegakan arteri yang menyempit, serta }\par\pard\l
i1906\ri0\sl-400\slmult0 \fs24\cf0\f0\charscalex100 {membantu menurunkan tekan
an darah. Sumber vitamin C terdapat pada buah jeruk, }\par\pard\li1906\r
i0\sl-386\slmult0 \fs24\cf0\f0\charscalex100 {anggur, kiwi, dan strawberry.
Vitamin C juga banyak ditemui pada sayuran seperti }\par\pard\li1906\ri0\
sl-386\slmult0 \fs24\cf0\f0\charscalex100 {kembang kol, paprika, dan kentang. }\
par\pard\li1893\ri0\sl-386\slmult0 \fs24\cf0\f0\charscalex100 {Makanan rendah so
dium }\par\pard\li1893\ri0\sl-386\slmult0 \fs24\cf0\f0\charscalex100 {Sodium me
mbuat tubuh menahan cairan yang masuk, dan membuat jantung anda }\par\p
ard\li1893\ri0\sl-400\slmult0 \fs24\cf0\f0\charscalex100 {harus bekerja ektra
kuat untuk memompa cairan lebih banyak, yang berakibat pada }\par\pard\
li1893\ri0\sl-386\slmult0 \fs24\cf0\f0\charscalex100 {hipertensi. Oleh sebab
itu disarankan untuk menurunkan kadar sodium anda agar }\par\pard\sect\se
ctd\sbkpage\pgwsxn12240\pghsxn15840\marglsxn666\margrsxn133\margtsxn666\margbsxn
333\pard\li1893\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1893\ri0\sl-213\slmult0
\fs18\cf0\par\pard\li1893\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1893\ri0\sl-32
0\slmult0 \fs24\cf0\f0\charscalex100 {berada pada batas normal, yaitu 2300
mg. Caranya yaitu dengan terlebih dahulu }\par\pard\li1893\ri0\sl-386\slmu
lt0 \fs24\cf0\f0\charscalex100 {mengecek label kandugan sodium yang tertera
pada kemasan makanan yang akan }\par\pard\li1893\ri0\sl-386\slmult0 \fs24\
cf0\f0\charscalex100 {anda konsumsi, serta pilihlah rempah-rempah atau her
ba sebagai penguat rasa }\par\pard\li1893\ri0\sl-386\slmult0 \fs24\cf0\f0\cha
rscalex100 {masakan anda dirumah. }\par\pard\li2293\ri0\sl-386\slmult0 \fs24\cf0
\f0\charscalex100 {Eklamsi berarti halilintar, maksudnya kejang-kejang bisa datang
dengan segera/ }\par\pard\li1626\ri0\sl-386\slmult0 \fs24\cf0\f0\charscalex100
{tiba-tiba, pada umumnya eklamsi didahului dengan preeklamsi yaitu kenai
kan tekanan }\par\pard\li1626\ri0\sl-400\slmult0 \fs24\cf0\f0\charscalex100 {da
rah dalam kehamilan lebih dari 5 bulan yang disertai dengan adanya protein dalam
air }\par\pard\li1626\ri0\sl-386\slmult0 \fs24\cf0\f0\charscalex100 {kencing.
Gejalanya dapat timbul bertahap, mula-mula terdapat kenaikan tekanan dar
ah }\par\pard\li1626\ri0\sl-386\slmult0 \fs22\cf0\f0\charscalex100 {yang ringan
(di atas 140/90mmHg; di bawah 160/110mmHg); sering disertai bengkak }\
par\pard\li1626\ri0\sl-386\slmult0 \fs24\cf0\f0\charscalex100 {pada muka, kelo
pak mata, punggung tangan atau pada kaki. Apabila sudah terjadi }\par\p
ard\li1626\ri0\sl-386\slmult0 \fs24\cf0\f0\charscalex100 {keadaan preeklamsi b
erat (tensi >160/110 mmHg) dapat (tidak selalu) disertai sakit }\par\par
d\li1626\ri0\sl-400\slmult0 \fs24\cf0\f0\charscalex100 {kepala, nyeri ulu hati a
tau penglihatan kabur. Itu sebabnya setiap pemeriksaan kehamilan }\par\pard\li16
26\ri0\sl-386\slmult0 \fs24\cf0\f0\charscalex100 {tekanan darah ibu hamil ha
rus selalu diperiksa dan diulangi apabila ada kecurigaan }\par\pard\li162
6\ri0\sl-386\slmult0 \fs24\cf0\f0\charscalex100 {terjadinya preeklamsi. }\par\pa
rd\li2293\ri0\sl-386\slmult0 \fs24\cf0\f0\charscalex100 {Penyebab preeklamsi y
ang pasti sampai saat ini belum ditemukan. Banyak teori }\par\pard\li1626\r
i0\sl-386\slmult0 \fs24\cf0\f0\charscalex100 {yang dikemukakan antara lain t
eori kekebalan (preeklamsi lebih sering pada wanita }\par\pard\li1626\ri0\
sl-400\slmult0 \fs24\cf0\f0\charscalex100 {hamil pertama kalinya), pada usia mud
a sekali (20 tahun) atau tua (35 tahun), pada hamil }\par\pard\li1626\ri0\sl-386
\slmult0 \fs24\cf0\f0\charscalex100 {yang besar (kembar, kebanyakan cairan/h
idramnion, atau bayi besar, pada ibu hamil }\par\pard\li1626\ri0\sl-386\sl
mult0 \fs22\cf0\f0\charscalex100 {dengan riwayat kencing manis, juga harus
dicurigai pada ibu yang pertambahan berat }\par\pard\li1626\ri0\sl-386\slm
ult0 \fs24\cf0\f0\charscalex100 {badan selama kehamilannya berlebihan. }\par\par

d\li2293\ri0\sl-386\slmult0 \fs24\cf0\f0\charscalex100 {Secara teori penyakit

ini juga berhubungan dengan keturunan, terutama apabila }\par\pard\li1626
\ri0\sl-386\slmult0 \fs24\cf0\f0\charscalex100 {hamil pada usia 35 tahun, mengal
ami hipertensi dsb. Makanan yang dihubungkan dengan }\par\pard\li1626\ri0\sl-400
\slmult0 \fs24\cf0\f0\charscalex100 {kejadian eklamsi adalah kurangnya asam
folat }\fs24\cf0\f0\charscalex100\i {fol}\i0 \fs24\cf0\f0\charscalex100\i {i}\i
0 \fs24\cf0\f0\charscalex100\i {c ac}\i0 \fs24\cf0\f0\charscalex100\i {i}\i0 \f
s24\cf0\f0\charscalex100\i {d}\i0 \fs24\cf0\f0\charscalex100 {, pengurangan ga
ram tidak }\par\pard\li1626\ri0\sl-386\slmult0 \fs24\cf0\f0\charscalex100 {berh
ubungan dengan turunnya kejadian preeklamsi. }\par\pard\li2293\ri0\sl-426\slmult
0 \fs24\cf0\f0\charscalex100 {K}\fs24\cf0\f0\charscalex100 {arena sebabnya bel
um diketahui pasti, maka pencegahannya sangat sulit. Saat }\par\pard\li16
26\ri0\sl-346\slmult0 \fs22\cf0\f0\charscalex100 {ini yang kami (pelayan kes
ehatan) lakukan adalah melakukan penyaringan faktor risiko }\par\pard\li1626
\ri0\sl-386\slmult0 \fs24\cf0\f0\charscalex100 {pada ibu hamil, memantaunya
dengan baik dan apabila timbul preeklamsi ringan ibu di }\par\pard\li1626\r
i0\sl-400\slmult0 \fs24\cf0\f0\charscalex100 {rawat serta diberi pengobatan
yang diperlukan. Pengobatan yang kami lakukan adalah }\par\pard\li1626\ri0
\sl-386\slmult0 \fs24\cf0\f0\charscalex100 {untuk pencegahan memberatnya keadaan
dan mencegah terjadinya kejang. }\par\pard\li2293\ri0\sl-386\slmult0 \fs24\cf0\
f0\charscalex100 {Sesuai dengan teori, preeklamsi dapat timbul karena kehamilan
janin yang hidup, }\par\pard\li1626\ri0\sl-386\slmult0 \fs24\cf0\f0\charscalex10
0 {maka apabila janin sudah meninggal di dalam rahim atau sudah lahir
maka gejala }\par\pard\li1626\ri0\sl-386\slmult0 \fs22\cf0\f0\charscalex100 {p
enyakit tersebut akan berkurang, kecuali apabila sudah ada komplikasi y
ang menetap. }\par\pard\li1626\ri0\sl-400\slmult0 \fs24\cf0\f0\charscalex100 {O
perasi untuk mengeluarkan janin yang meninggal dalam rahim jarang sekali dilakuk
an }\par\pard\li1626\ri0\sl-386\slmult0 \fs24\cf0\f0\charscalex100 {kecuali jel
as-jelas diperlukan untuk menyelamatkan nyawa ibu. Saat ini cukup banya
k }\par\pard\sect\sectd\sbkpage\pgwsxn12240\pghsxn15840\marglsxn666\margrsxn133\
margtsxn666\margbsxn666\pard\li1626\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1626
\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1626\ri0\sl-213\slmult0 \fs18\cf0\par\p
ard\li1626\ri0\sl-320\slmult0 \fs22\cf0\f0\charscalex100 {ibu hamil dengan pr
eeklamsi berat dan eklamsi yang tertolong apabila cepat terdeteksi }\par
\pard\li1626\ri0\sl-386\slmult0 \fs22\cf0\f0\charscalex100 {penyakitnya (sebelum
terjadi kejang), segera diberi pengobatan anti kejang dan dirujuk }\pa
r\pard\li1626\ri0\sl-413\slmult0 \fs22\cf0\f0\charscalex100 {ke rumah sakit yang
tepat. }{ }\fs22\cf0\f0\charscalex100 {K}\fs22\cf0\f0\charscalex100 {eterlambat
an penanganan atau rujukan sering menyebabkan }\par\pard\li1626\ri0\sl-360\slmul
t0 \fs24\cf0\f0\charscalex100 {kematian janin maupun ibunya. Eklamsi merupakan
salah satu dari tiga besar penyebab }\par\pard\li1626\ri0\sl-386\slmult0 \fs24\
cf0\f0\charscalex100 {kematian ibu (perdarahan, hipertensi dalam kehamilan
dan infeksi) di seluruh dunia, }\par\pard\li1626\ri0\sl-386\slmult0 \fs24\c
f0\f0\charscalex100 {bukan hanya di Indonesia (Anonim, 2009). }\par\pard\sect\se
ctd\sbkpage\pgwsxn12240\pghsxn15840\marglsxn666\margrsxn133\margtsxn666\margbsxn
400\cols3\colno1\colw3933\colsr-0\colno2\colw786\colsr-0\colno3\colw6720\pard\li
1226\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1226\ri0\sl-213\slmult0 \fs18\cf0\p
ar\pard\li1226\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1226\ri0\sl-213\slmult0 \
fs18\cf0\par\pard\li1226\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1226\ri0\sl-213
\slmult0 \fs18\cf0\par\pard\li1226\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1226\
ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1226\ri0\sl-213\slmult0 \fs18\cf0\par\pa
rd\li1226\ri0\sl-213\slmult0 \fs24\cf0\f0\charscalex100\b {3.1 Resep }\b0 \par\p
ard\li1626\ri0\sl-413\slmult0 \fs24\cf0\f0\charscalex100 {R}\fs24\cf0\f0\charsca
lex100 {/ Captopril 25 mg }\par\pard\li1906\ri0\sl-346\slmult0 \fs24\cf0\f0\char
scalex100 {s.3.d.d.1 }\par\column\pard\li0\ri0\sl-213\slmult0 \fs18\cf0\par\pard
\li0\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li0\ri0\sl-213\slmult0 \fs18\cf0\par\
pard\li0\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li0\ri0\sl-213\slmult0 \fs18\cf0\
par\pard\li0\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li0\ri0\sl-213\slmult0 \fs18\
cf0\par\pard\li0\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li0\ri0\sl-213\slmult0 \f
s18\cf0\par\pard\li0\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li0\ri0\sl-373\slmult

0 \fs24\cf0\f0\charscalex100 {No.XV }\par\column\pard\li360\ri0\sl-213\slmult0 \

fs18\cf0\par\pard\li360\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li360\ri0\sl-213\s
lmult0 \fs18\cf0\par\pard\li360\ri0\sl-320\slmult0 \fs24\cf0\f0\charscalex100\b
{BAB III }\b0 \par\pard\li0\ri0\sl-400\slmult0 \fs24\cf0\f0\charscalex100\b {STU
DI KASUS }\b0 \par\pard\sect\sectd\sbknone\pgwsxn12240\pghsxn15840\marglsxn666\m
argrsxn133\pard\li1626\ri0\sl-426\slmult0 \*\tx3933\fs24\cf0\f0\charscalex100 {R
}\fs24\cf0\f0\charscalex100 {/ Furosemida 40 mg }\tab \fs24\cf0\f0\charscalex100
{No.V }\par\pard\li1906\ri0\sl-360\slmult0 \fs24\cf0\f0\charscalex100 {s.1 tab
pagi }\par\pard\sect\sectd\sbknone\pgwsxn12240\pghsxn15840\marglsxn666\margrsxn1
33\cols2\colno1\colw3933\colsr-0\colno2\colw7506\pard\li1626\ri0\sl-426\slmult0
\fs24\cf0\f0\charscalex100 {R}\fs24\cf0\f0\charscalex100 {/ Valisanbe 5 mg }\par
\pard\li1906\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {s.1/2-1/2-1 tab }\pa
r\pard\li1626\ri0\sl-426\slmult0 \fs24\cf0\f0\charscalex100 {R}\fs24\cf0\f0\char
scalex100 {/ Lapibal tab }\par\pard\li1906\ri0\sl-360\slmult0 \fs24\cf0\f0\chars
calex100 {s.2.d.d.1 }\par\pard\li1626\ri0\sl-426\slmult0 \fs24\cf0\f0\charscalex
100 {R}\fs24\cf0\f0\charscalex100 {/ Paracetamol tab }\par\pard\li1906\ri0\sl-34
6\slmult0 \fs24\cf0\f0\charscalex100 {s.2.d.d.1 }\par\pard\li1626\ri0\sl-386\slm
ult0 \*\tx2573\fs24\cf0\f0\charscalex100 {Pro }\tab \fs24\cf0\f0\charscalex100 {
: Ibu Yanti }\par\pard\li1626\ri0\sl-386\slmult0 \*\tx2573\fs24\cf0\f0\charscale
x100 {Umur }\tab \fs24\cf0\f0\charscalex100 {: 32 tahun }\par\pard\li1226\ri0\sl
-213\slmult0 \fs18\cf0\par\pard\li1226\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1
226\ri0\sl-240\slmult0 \fs24\cf0\f0\charscalex100\b {3.2 Kasus }\b0 \par\column\
pard\li0\ri0\sl-386\slmult0 \fs24\cf0\f0\charscalex100 {No.X }\par\pard\li0\ri0\
sl-213\slmult0 \fs18\cf0\par\pard\li0\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li0\
ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {No.X }\par\pard\li0\ri0\sl-213\sl
mult0 \fs18\cf0\par\pard\li0\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li0\ri0\sl-36
0\slmult0 \fs24\cf0\f0\charscalex100 {No.X }\par\pard\sect\sectd\sbknone\pgwsxn1
2240\pghsxn15840\marglsxn666\margrsxn133\pard\li2293\ri0\sl-373\slmult0 \fs24\cf
0\f0\charscalex100 {Ibu Yanti usia 32 tahun sedang mengalami kehamilan t
risemester 3 saat ini }\par\pard\li1626\ri0\sl-386\slmult0 \fs24\cf0\f0\chars
calex100 {menderita penyakit hipertensi dengan gejala kenaikan tekanan darah tin
ggi, pegal-pegal, }\par\pard\li1626\ri0\sl-400\slmult0 \fs20\cf0\f0\charscalex10
0 {nyeri dan pusing. Ibu Yanti juga mengeluh bahwa beliau mengalami su
sah tidur. Oleh }\par\pard\li1626\ri0\sl-386\slmult0 \fs22\cf0\f0\charscalex10
0 {karena itu, dokter memberikan obat valisanbe dengan kandungan diazepa
m yang }\par\pard\li1626\ri0\sl-386\slmult0 \fs24\cf0\f0\charscalex100 {menimbu
lkan efek sedatif. Suatu hari ibu Yanti pergi ke sebuah apotek Himafa
rma }\par\pard\li1626\ri0\sl-386\slmult0 \fs22\cf0\f0\charscalex100 {dengan mem
bawa resep yang diberikan oleh dokter Leodora. Berdasarkan resep yang }
\par\pard\li1626\ri0\sl-386\slmult0 \fs22\cf0\f0\charscalex100 {telah diberikan
oleh dokter, terjadi ketidakrasionalan resep yaitu ketidak tepatan }\pa
r\pard\li1626\ri0\sl-386\slmult0 \fs24\cf0\f0\charscalex100 {pemilihan obat yait
u Captopril untuk ibu hamil. }\par\pard\li1226\ri0\sl-213\slmult0 \fs18\cf0\par\
pard\li1226\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1226\ri0\sl-240\slmult0 \fs2
4\cf0\f0\charscalex100\b {2.3 Informasi Obat }\b0 \par\pard\li1626\ri0\sl-373\sl
mult0 \fs24\cf0\f0\charscalex100 {a. Captopril }\par\pard\li2293\ri0\sl-400\slmu
lt0 \fs22\cf0\f0\charscalex100 {Indikasi dari Captopril adalah untuk hiperte
nsi berat hingga sedang, kombinasi }\par\pard\li1626\ri0\sl-386\slmult0 \fs2
2\cf0\f0\charscalex100 {dengan tiazida memberikan efek aditif, sedangkan k
ombinasi dengan beta bloker }\par\pard\li1626\ri0\sl-386\slmult0 \fs24\cf0\f0
\charscalex100 {memberikan efek yang kurang aditif. Untuk gagal jantung
yang tidak cukup responsif }\par\pard\li1626\ri0\sl-386\slmult0 \fs24\cf0\f0\
charscalex100 {atau tidak dapat dikontrol dengan diuretik dan digitalis,
dalam hal ini pemberian }\par\pard\li1626\ri0\sl-386\slmult0 \fs24\cf0\f0\ch
arscalex100 {kaptopril diberikan bersama diuretik dan digitalis. Captopril tidak
boleh dikonsumsi oleh }\par\pard\sect\sectd\sbknone\pgwsxn12240\pghsxn15840\mar
glsxn666\margrsxn133\pard\sect\sectd\sbkpage\pgwsxn12240\pghsxn15840\marglsxn666
\margrsxn133\margtsxn666\margbsxn333\pard\li1626\ri0\sl-213\slmult0 \fs18\cf0\pa
r\pard\li1626\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1626\ri0\sl-213\slmult0 \f
s18\cf0\par\pard\li1626\ri0\sl-320\slmult0 \fs24\cf0\f0\charscalex100 {penderita

yang hipersensitif terhadap kaptopril atau penghambat ACE lainnya (misalnya }\p
ar\pard\li1626\ri0\sl-386\slmult0 \fs24\cf0\f0\charscalex100 {pasien mengalami a
ngioedema selama pengobatan dengan penghambat ACE lainnya). }\par\pard\li1626\ri
0\sl-386\slmult0 \fs24\cf0\f0\charscalex100 {b. Furosemida }\par\pard\li2426\ri0
\sl-386\slmult0 \fs24\cf0\f0\charscalex100 {Furosemida adalah diuretik deriva
t asam antranilat. Aktivitas diuretik }\par\pard\li1626\ri0\sl-386\slmult0 \
fs22\cf0\f0\charscalex100 {furosemida terutama dengan jalan menghambat abso
rpsi natrium dan klorida, tidak }\par\pard\li1626\ri0\sl-386\slmult0 \fs24\c
f0\f0\charscalex100 {hanya pada tubulus proksimal dan tubulus distal, tapi juga
pada loop of Henle. }\par\pard\li2426\ri0\sl-400\slmult0 \fs24\cf0\f0\charscalex
100 {Tempat kerja yang spesifik ini menghasilkan efektivitas kerja yang
tinggi. }\par\pard\li1626\ri0\sl-386\slmult0 \fs22\cf0\f0\charscalex100 {Efekti
vitas kerja furosemida ditingkatkan dengan efek vasodilatasi dan penurun
an }\par\pard\li1626\ri0\sl-386\slmult0 \fs24\cf0\f0\charscalex100 {hambatan vas
kuler sehingga akan meningkatkan aliran darah ke ginjal. Furosemida juga }\par\p
ard\li1626\ri0\sl-386\slmult0 \fs24\cf0\f0\charscalex100 {menunjukkan aktivitas
menurunkan tekanan darah sebagai akibat penurunan volume }\par\pard\li1626
\ri0\sl-386\slmult0 \fs24\cf0\f0\charscalex100 {plasma. }\par\pard\li2426\ri0\sl
-400\slmult0 \fs24\cf0\f0\charscalex100 {Indikasi dari Furosemida adalah diu
retik derivat asam antranilat. Aktivitas }\par\pard\li1626\ri0\sl-386\slmult
0 \fs24\cf0\f0\charscalex100 {diuretik furosemida terutama dengan jalan men
ghambat absorpsi natrium dan klorida, }\par\pard\li1626\ri0\sl-386\slmult0 \
fs24\cf0\f0\charscalex100 {tidak hanya pada tubulus proksimal dan tubulus distal
, tapi juga pada loop of Henle. }\par\pard\li2426\ri0\sl-386\slmult0 \fs24\cf0\f
0\charscalex100 {Tempat kerja yang spesifik ini menghasilkan efektivitas
kerja yang tinggi. }\par\pard\li1626\ri0\sl-386\slmult0 \fs24\cf0\f0\charscale
x100 {Efektivitas kerja furosemida ditingkatkan dengan efek vasodilatasi
dan penurunan }\par\pard\li1626\ri0\sl-400\slmult0 \fs22\cf0\f0\charscalex100 {
hambatan vaskuler sehingga akan meningkatkan aliran darah ke ginjal. Furosemida
juga }\par\pard\li1626\ri0\sl-386\slmult0 \fs24\cf0\f0\charscalex100 {menunjukka
n aktivitas menurunkan tekanan darah sebagai akibat penurunan volume }\par
\pard\li1626\ri0\sl-386\slmult0 \fs24\cf0\f0\charscalex100 {plasma. }\par\pard\l
i1226\ri0\sl-386\slmult0 \fs24\cf0\f0\charscalex100 {c. Valisanbe }\par\pard\li2
426\ri0\sl-386\slmult0 \*\tx3413\*\tx4026\*\tx5200\*\tx7160\*\tx8586\fs24\cf0\f0
\charscalex100 {Indikasi }\tab \fs24\cf0\f0\charscalex100 {dari }\tab \fs24\cf0\
f0\charscalex100 {Valisanbe }\tab \fs24\cf0\f0\charscalex100 {adalah Hipnotik,
}\tab \fs24\cf0\f0\charscalex100 {antikonvulsi, }\tab \fs24\cf0\f0\charscalex100
{antiansietas, }\par\pard\li1626\ri0\sl-386\slmult0 \fs22\cf0\f0\charscalex100
{psikoneurosis, status epileptikus (IV), pre dan post operasi, tetanus, alk
oholisme (terapi }\par\pard\li1626\ri0\sl-426\slmult0 \*\tx2880\fs24\cf0\f0\cha
rscalex100 {penunjang). }\tab \fs24\cf0\f0\charscalex100 {K}\fs24\cf0\f0\charsca
lex100 {ontraindikasinya adalah Depresi pernafasan, serangan asma akut, }\
par\pard\li1626\ri0\sl-360\slmult0 \fs24\cf0\f0\charscalex100 {insufisiensi pul
moner akut, gangguan hati berat, myasthenia gravis, trimester I }\par\pa
rd\li1626\ri0\sl-386\slmult0 \fs24\cf0\f0\charscalex100 {kehamilan. }\par\pard\l
i1226\ri0\sl-386\slmult0 \fs24\cf0\f0\charscalex100 {d. Lapibal }\par\pard\li242
6\ri0\sl-386\slmult0 \*\tx4600\*\tx6173\*\tx7493\*\tx8533\fs24\cf0\f0\charscalex
100 {Lapibal mengandung }\tab \fs24\cf0\f0\charscalex100 {Mecobalamin, }\tab \fs
24\cf0\f0\charscalex100 {mempunyai }\tab \fs24\cf0\f0\charscalex100 {aktivitas }
\tab \fs24\cf0\f0\charscalex100 {memperbaiki }\par\pard\li1626\ri0\sl-400\slmult
0 \fs22\cf0\f0\charscalex100 {gangguan metabolisme asam nukleat dan protein
di dalam jaringan saraf serta }\par\pard\li1626\ri0\sl-386\slmult0 \fs24\c
f0\f0\charscalex100 {memperbaiki gangguan saraf sensoris dan motoris. Seca
ra biokimia, Mecobalamin }\par\pard\li1626\ri0\sl-386\slmult0 \fs22\cf0\f0\cha
rscalex100 {berhubungan erat dengan proses transmetilasi sebagai Co-enzym
B12 yang terdapat di }\par\pard\li1626\ri0\sl-386\slmult0 \fs24\cf0\f0\chars
calex100 {dalam darah, dan merupakan homolog vitamin B12. Selanjutnya ef
ek Mecobalamin }\par\pard\li1626\ri0\sl-386\slmult0 \fs24\cf0\f0\charscalex100
{membantu proses myelinogenesis dan regenerasi saraf. Indikasi dari Lapi
bal adalah }\par\pard\li1626\ri0\sl-400\slmult0 \fs24\cf0\f0\charscalex100 {Unt

uk pengobatan gangguan saraf perifer. Peringatan dari obat ini adalah B

ila dalam }\par\pard\li1626\ri0\sl-386\slmult0 \fs24\cf0\f0\charscalex100 {jang
ka waktu tertentu tidak ada respon sama sekali, sebaiknya pemakaian ti
dak }\par\pard\sect\sectd\sbkpage\pgwsxn12240\pghsxn15840\marglsxn666\margrsxn13
3\margtsxn666\margbsxn373\pard\li1626\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li16
26\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1626\ri0\sl-213\slmult0 \fs18\cf0\par
\pard\li1626\ri0\sl-320\slmult0 \fs22\cf0\f0\charscalex100 {dilanjutkan dan pa
da penderita hipersensitif akan menimbulkan rasa mual, diare, nafsu }\pa
r\pard\li1626\ri0\sl-386\slmult0 \fs22\cf0\f0\charscalex100 {makan berkurang a
tau terjadi gangguan-gangguan ringan pada gastrointestinal, namun }\par\pa
rd\li1626\ri0\sl-386\slmult0 \fs24\cf0\f0\charscalex100 {hal ini sangat jarang t
erjadi. }\par\pard\li1626\ri0\sl-386\slmult0 \fs24\cf0\f0\charscalex100 {e. Para
cetamol }\par\pard\li2426\ri0\sl-386\slmult0 \fs24\cf0\f0\charscalex100 {Indikas
i dari Paracetamol adalah sebagai antipiretik/analgesik, termasuk bagi }\p
ar\pard\li1626\ri0\sl-386\slmult0 \fs22\cf0\f0\charscalex100 {pasien yang tida
k tahan asetosal. Sebagai analgesik, misalnya untuk mengurangi rasa }\par
\pard\li1626\ri0\sl-400\slmult0 \fs24\cf0\f0\charscalex100 {nyeri pada sakit
kepala, sakit gigi, sakit waktu haid dan sakit pada otot.menurunkan }\p
ar\pard\li1626\ri0\sl-426\slmult0 \fs24\cf0\f0\charscalex100 {demam pada influ
enza dan setelah vaksinasi. }{ }\fs24\cf0\f0\charscalex100 {K}\fs24\cf0\f0\ch
arscalex100 {ontra indikasinya adalah hipersensitif }\par\pard\li1626\ri0\sl-3
46\slmult0 \fs24\cf0\f0\charscalex100 {terhadap parasetamol dan defisiensi g
lokose-6-fosfat dehidroganase.tidak boleh }\par\pard\li1626\ri0\sl-386\slmult0
\fs24\cf0\f0\charscalex100 {digunakan pada penderita dengan gangguan fungsi hat
i (Tjay, 2002). }\par\pard\li1226\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1226\r
i0\sl-213\slmult0 \fs18\cf0\par\pard\li1226\ri0\sl-266\slmult0 \fs24\cf0\f0\char
scalex100 {2.4 Penyelesaian }\fs24\cf0\f0\charscalex100 {K}\fs24\cf0\f0\charscal
ex100 {asus }\par\pard\li2293\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {Ibu
Yanti sedang hamil memasuki trisemester 3. Beliau mengalami hipertensi
}\par\pard\li1626\ri0\sl-386\slmult0 \fs24\cf0\f0\charscalex100 {yang diiringi
dengan gejala kenaikan tekanan darah, pegal-pegal, nyeri dan pusing. Ib
u }\par\pard\li1626\ri0\sl-400\slmult0 \fs24\cf0\f0\charscalex100 {Yanti pergi
ke dokter dan mendapatkan resep yang terdiri dari beberapa obat yaitu
}\par\pard\li1626\ri0\sl-413\slmult0 \fs22\cf0\f0\charscalex100 {Captopril 25
mg, Furosemid 40 mg, Valisanbe 5 mg, Lapibal dan Paracetamol. }{ }\fs2
4\cf0\f0\charscalex100 {R}\fs24\cf0\f0\charscalex100 {esep }\par\pard\li1626\ri0
\sl-360\slmult0 \fs24\cf0\f0\charscalex100 {dibawa ke apotek Himafarma yang
diterima oleh asisten apoteker dan dianalisis oleh }\par\pard\li1626\ri0\
sl-386\slmult0 \fs24\cf0\f0\charscalex100 {apotekernya. Setelah dianalisis, rese
p tersebut ternyata tidak rasional. Ada beberapa obat }\par\pard\li1626\ri0\sl-3
86\slmult0 \fs24\cf0\f0\charscalex100 {yang terkandung di dalam resep terse
but kontra indikasi terhadap ibu hamil seperti }\par\pard\li1626\ri0\sl-38
6\slmult0 \fs24\cf0\f0\charscalex100 {Captopril, Furosemida dan Valisanbe. S
ehingga dikhawatirkan obat tersebut dapat }\par\pard\li1626\ri0\sl-400\slmul
t0 \fs24\cf0\f0\charscalex100 {memperparah penyakit dan mengganggu kehamilan dar
i Ibu Yanti. Apoteker yang sadar }\par\pard\li1626\ri0\sl-386\slmult0 \fs24\cf0\
f0\charscalex100 {terhadap kasus tersebut harus segera menghubungi dokter untuk
meminta izin agar resep }\par\pard\li1626\ri0\sl-386\slmult0 \fs24\cf0\f0\chars
calex100 {diganti dengan obat-obat yang lebih aman untuk ibu hamil. }\par\pard\
li2293\ri0\sl-386\slmult0 \fs22\cf0\f0\charscalex100 {Captopril dan Furosemid
dalam resep perlu diganti dengan obat lain yang juga }\par\pard\li1626\
ri0\sl-386\slmult0 \fs24\cf0\f0\charscalex100 {memiliki efek yang sama sebagai a
ntihipertensi. Alasan digantinya obat ini karena kedua }\par\pard\li1626\ri0\sl386\slmult0 \fs24\cf0\f0\charscalex100 {obat ini melewati plasenta, dan diekskre
sikan lewat air susu ibu (ASI) mengingat pasien }\par\pard\li1626\ri0\sl-400\slm
ult0 \fs24\cf0\f0\charscalex100 {dalam keadaan hamil trisemester ketiga. Pe
nggunaan Captopril menimbulkan efek }\par\pard\li1626\ri0\sl-386\slmult0 \fs2
4\cf0\f0\charscalex100 {samping berupa batuk yang dapat memperparah ganggu
an tidur ibu Yanti. Selain itu, }\par\pard\li1626\ri0\sl-386\slmult0 \fs24\
cf0\f0\charscalex100 {penggunaan Furosemid dapat menimbulkan efek diuresis

karena mekanisme obat ini }\par\pard\li1626\ri0\sl-386\slmult0 \fs24\cf0\f0\

charscalex100 {menginduksi pelepasan ion Na}{\super \fs16\up4\cf0\f0\charscal
ex100 {+}}\fs24\cf0\f0\charscalex100 { yang dapat mengikat air dan menyeba
bkan ibu Yanti }\par\pard\li1626\ri0\sl-386\slmult0 \fs22\cf0\f0\charscalex100
{akan lebih sering buang air kecil apalagi jika ibu Yanti menggunakan
obat ini sebelum }\par\pard\li1626\ri0\sl-400\slmult0 \fs24\cf0\f0\charscalex1
00 {tidur juga. Adapun alternatif }\fs24\cf0\f0\charscalex100\i {opt}\i0 \fs2
4\cf0\f0\charscalex100\i {i}\i0 \fs24\cf0\f0\charscalex100\i {onal}\i0 \fs22\cf0
\f0\charscalex100 { antihipertensi pengganti Captopril dan furosemid }\par\
pard\li1626\ri0\sl-386\slmult0 \fs24\cf0\f0\charscalex100 {adalah Metildopa ya
ng memiliki aktivitas antihipertensi dengan mekanisme blokade }\par\pard\l
i1626\ri0\sl-386\slmult0 \fs24\cf0\f0\charscalex100 {reseptor I. }\par\pard\sect
\sectd\sbkpage\pgwsxn12240\pghsxn15840\marglsxn666\margrsxn133\margtsxn666\margb
sxn333\pard\li2293\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2293\ri0\sl-213\slmul
t0 \fs18\cf0\par\pard\li2293\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2293\ri0\sl
-320\slmult0 \fs24\cf0\f0\charscalex100 {Valisanbe dengan kandungan zat akti
f berupa Diazepam kurang aman jika }\par\pard\li1626\ri0\sl-386\slmult0 \fs
24\cf0\f0\charscalex100 {digunakan pada ibu hamil karena Diazepam dapat masuk me
lalui plasenta sehingga akan }\par\pard\li1626\ri0\sl-386\slmult0 \fs24\cf0\f0\c
harscalex100 {menimbulkan efek samping bagi neonatus berupa hiperbilirubinemia.
Sebaiknya obat ini }\par\pard\li1626\ri0\sl-386\slmult0 \fs24\cf0\f0\charscalex1
00 {tidak digunakan. Paracetamol tetap digunakan karena indikasinya untuk
mengurangi }\par\pard\li1626\ri0\sl-386\slmult0 \fs24\cf0\f0\charscalex100 {ny
eri dan pusing pada pasien. Dengan informasi yang diberikan kepada dok
ter maka }\par\pard\li1626\ri0\sl-386\slmult0 \fs24\cf0\f0\charscalex100 {dokte
r akan menyetujui apabila resep diubah menjadi : }\par\pard\li1626\ri0\sl-426\sl
mult0 \fs24\cf0\f0\charscalex100 {R}\fs24\cf0\f0\charscalex100 {esep setelah diu
bah : }\par\pard\li1626\ri0\sl-400\slmult0 \*\tx3933\fs24\cf0\f0\charscalex100 {
R}\fs24\cf0\f0\charscalex100 {/ Metildopa 250 mg }\tab \fs24\cf0\f0\charscalex10
0 {No.XV }\par\pard\li1906\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {s.2.d.
d.1 }\par\pard\sect\sectd\sbknone\pgwsxn12240\pghsxn15840\marglsxn666\margrsxn13
3\cols2\colno1\colw3933\colsr-0\colno2\colw7506\pard\li1626\ri0\sl-426\slmult0 \
fs24\cf0\f0\charscalex100 {R}\fs24\cf0\f0\charscalex100 {/ Lapibal tab }\par\par
d\li1906\ri0\sl-346\slmult0 \fs24\cf0\f0\charscalex100 {s.2.d.d.1 }\par\pard\li1
626\ri0\sl-426\slmult0 \fs24\cf0\f0\charscalex100 {R}\fs24\cf0\f0\charscalex100
{/ Paracetamol tab }\par\pard\li1906\ri0\sl-360\slmult0 \fs24\cf0\f0\charscalex1
00 {s.2.d.d.1 }\par\pard\li1626\ri0\sl-386\slmult0 \*\tx2573\fs24\cf0\f0\charsca
lex100 {Pro }\tab \fs24\cf0\f0\charscalex100 {: Ibu Yanti }\par\pard\li1626\ri0\
sl-386\slmult0 \*\tx2573\fs24\cf0\f0\charscalex100 {Umur }\tab \fs24\cf0\f0\char
scalex100 {: 32 tahun }\par\pard\li1226\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li
1226\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1226\ri0\sl-386\slmult0 \fs24\cf0\f
0\charscalex100 {2.5 }\fs24\cf0\f0\charscalex100 {K}\fs24\cf0\f0\charscalex100 {
onseling }\par\column\pard\li0\ri0\sl-386\slmult0 \fs24\cf0\f0\charscalex100 {No
.X }\par\pard\li0\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li0\ri0\sl-213\slmult0 \
fs18\cf0\par\pard\li0\ri0\sl-360\slmult0 \fs24\cf0\f0\charscalex100 {No.X }\par\
pard\sect\sectd\sbknone\pgwsxn12240\pghsxn15840\marglsxn666\margrsxn133\pard\li2
293\ri0\sl-360\slmult0 \fs22\cf0\f0\charscalex100 {Pada tahap konseling ini
pasien akan memberikan resep ke sebuah apotek, dan }\par\pard\li1626\ri0\
sl-413\slmult0 \fs24\cf0\f0\charscalex100 {akan dilayani oleh asisten apoteker.
}\fs24\cf0\f0\charscalex100 {K}\fs24\cf0\f0\charscalex100 {emudian menyadari ada
kesalahan pada peresepan }\par\pard\li1626\ri0\sl-360\slmult0 \fs24\cf0\f0\char
scalex100 {asisten apoteker akan menginformasikan kepada dokter yang menu
lis resep tersebut }\par\pard\li1626\ri0\sl-386\slmult0 \fs24\cf0\f0\charscale
x100 {untuk mengubah obat di dalam resep dengan obat yang aman bagi pasien apala
gi pasien }\par\pard\li1626\ri0\sl-426\slmult0 \fs24\cf0\f0\charscalex100 {ini
sedang hamil. }{ }\fs24\cf0\f0\charscalex100 {K}\fs22\cf0\f0\charscalex100 {omu
nikasi dengan dokter dapat melalui media telfon atau bertemu }\par\pard\
li1626\ri0\sl-360\slmult0 \fs24\cf0\f0\charscalex100 {langsung apabila memungk
inkan, informasi yang diberikan kepada dokter harus }\par\pard\li1626\ri0\
sl-386\slmult0 \fs24\cf0\f0\charscalex100 {merupakan informasi yang jelas da

n disertai alasan yang kuat. Pada kasus ini pasien }\par\pard\li1626\ri0

\sl-386\slmult0 \fs24\cf0\f0\charscalex100 {tidak boleh mengkonsumsi obat ca
ptropil, furosemide, dan valisanbe karena dapat }\par\pard\li1626\ri0\sl-38
6\slmult0 \fs24\cf0\f0\charscalex100 {menggangu kehamilan dan janin di dala
mnya. Oleh karena itu apoteker harus }\par\pard\li1626\ri0\sl-386\slmult0 \
fs24\cf0\f0\charscalex100 {memberikan suatu informasi yang jelas pada dokt
er dan memberikan alternatif }\par\pard\li1626\ri0\sl-400\slmult0 \fs24\cf0\f
0\charscalex100 {penyelesaian masalah tersebut. Oleh karena itu resep akan diuba
h atas persetujuan dokter }\par\pard\li1626\ri0\sl-386\slmult0 \fs24\cf0\f0\char
scalex100 {yang terkait menjadi 3 macam obat saja yaitu metildopa, lapibal, dan
paracetamol. }\par\pard\li2293\ri0\sl-426\slmult0 \fs24\cf0\f0\charscalex100 {R
}\fs22\cf0\f0\charscalex100 {esep yang telah diubah dan mendapat persetuju
an dokter segera disiapkan dan }\par\pard\li1626\ri0\sl-346\slmult0 \fs24\cf
0\f0\charscalex100 {diberikan pada pasien. Untuk berkomunikasi dengan pasi
en, apoteker harus membuka }\par\pard\li1626\ri0\sl-386\slmult0 \fs24\cf0\f0\
charscalex100 {pembicaraan dengan sopan dan berkata-kata halus untuk meny
enangkan hati pasien. }\par\pard\li1626\ri0\sl-400\slmult0 \fs24\cf0\f0\charsc
alex100 {Menanyakan nama dan keadaan pasien merupakan kata-kata yang dapat digun
akan untuk }\par\pard\li1626\ri0\sl-386\slmult0 \fs24\cf0\f0\charscalex100 {memb
uka pembicaraan. Setelah pasien merasa nyaman dengan komunikasi dua ara
h }\par\pard\sect\sectd\sbknone\pgwsxn12240\pghsxn15840\marglsxn666\margrsxn133\
pard\sect\sectd\sbkpage\pgwsxn12240\pghsxn15840\marglsxn666\margrsxn133\margtsxn
666\margbsxn666\pard\li1626\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1626\ri0\sl213\slmult0 \fs18\cf0\par\pard\li1626\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li16
26\ri0\sl-320\slmult0 \fs22\cf0\f0\charscalex100 {tersebut, apoteker harus me
mberikan obat yang telah disiapkan dan dijelaskan masing-}\par\pard\li162
6\ri0\sl-386\slmult0 \fs24\cf0\f0\charscalex100 {masing obat dan cara pemaka
iannya. Sebelumnya pasien diberitahu terlebih dahulu }\par\pard\li1626\ri0\
sl-386\slmult0 \fs24\cf0\f0\charscalex100 {mengenai perubahan resep dan alas
annya mengapa resep diubah sehingga pasien }\par\pard\li1626\ri0\sl-386\slm
ult0 \fs22\cf0\f0\charscalex100 {memahami dan tidak menggunakan sembarangan
obat ketika sedang hamil. Selain
itu }\par\pard\li1626\ri0\sl-386\slmult
0 \fs22\cf0\f0\charscalex100 {pesien juga harus terlebih dahulu mengetahui
harga semua obat dalam resep apabila }\par\pard\li1626\ri0\sl-386\slmult0
\fs22\cf0\f0\charscalex100 {diambil semuanyam sehingga pasien akan memberik
an pilihan apakah akan membeli }\par\pard\li1626\ri0\sl-400\slmult0 \fs24\cf
0\f0\charscalex100 {resep penuh atau Cuma setengah saja. Untuk resep ter
sebut ada 3 jenis obat dalam }\par\pard\li1626\ri0\sl-386\slmult0 \fs24\cf0
\f0\charscalex100 {sediaan jadi, sehingga apoteker harus memberikan informasi me
ngenai penggunaan obat }\par\pard\li1626\ri0\sl-386\slmult0 \fs24\cf0\f0\charsca
lex100 {tersebut. }\par\pard\sect\sectd\sbknone\pgwsxn12240\pghsxn15840\marglsxn
666\margrsxn133\cols2\colno1\colw2160\colsr-0\colno2\colw9280\pard\li1626\ri0\sl
-213\slmult0 \fs18\cf0\par\pard\li1626\ri0\sl-226\slmult0 \fs24\cf0\f0\charscale
x100 {y}\par\pard\li1626\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1626\ri0\sl-213
\slmult0 \fs18\cf0\par\pard\li1626\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1626\
ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1626\ri0\sl-333\slmult0 \fs22\cf0\f0\cha
rscalex100 {y}\par\pard\li1626\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1626\ri0\
sl-213\slmult0 \fs18\cf0\par\pard\li1626\ri0\sl-213\slmult0 \fs18\cf0\par\pard\l
i1626\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1626\ri0\sl-333\slmult0 \fs22\cf0\
f0\charscalex100 {y}\par\column\pard\li0\ri0\sl-400\slmult0 \fs22\cf0\f0\charsca
lex100 {Metildopa, merupakan antihipertensi dengan sediaan 250 mg dan di
minum 2 kali }\par\pard\li0\ri0\sl-400\slmult0 \fs24\cf0\f0\charscalex100 {seh
ari 1 tablet pada siang dan malam hari dengan selang minum 12 jam, diminum }\par
\pard\li0\ri0\sl-386\slmult0 \fs24\cf0\f0\charscalex100 {sebelum makan. }\par\pa
rd\li0\ri0\sl-400\slmult0 \fs24\cf0\f0\charscalex100 {Lavibal, merupakan multivi
tamin dengan sediaan 15 mg dan diminum 2 kali sehari }\par\pard\li0\ri0\sl-386\s
lmult0 \fs24\cf0\f0\charscalex100 {1 tablet pada siang dan malam hari den
gan selang minum 12 jam, diminum }\par\pard\li0\ri0\sl-400\slmult0 \fs24\cf
0\f0\charscalex100 {sebelum makan. }\par\pard\li0\ri0\sl-400\slmult0 \fs24\cf0\f
0\charscalex100 {Paracetamol, merupakan analgetik dengan sediaan 500 mg d

an diminum 2 kali }\par\pard\li0\ri0\sl-386\slmult0 \fs24\cf0\f0\charscalex10

0 {sehari 1 tablet pada siang dan malam hari dengan selang minum 12 jam, diminum
}\par\pard\li0\ri0\sl-386\slmult0 \fs24\cf0\f0\charscalex100 {sebelum makan. }\
par\pard\li133\ri0\sl-400\slmult0 \fs24\cf0\f0\charscalex100 {Setelah memberika
n informasi tentang cara penggunaan obat, apoteker dapat }\par\pard\sect\
sectd\sbknone\pgwsxn12240\pghsxn15840\marglsxn666\margrsxn133\pard\li1626\ri0\sl
-386\slmult0 \fs24\cf0\f0\charscalex100 {menanyakan kembali kepada pasien tentan
g resep tersebut. Hal ini dapat dilakukan untuk }\par\pard\li1626\ri0\sl-426\slm
ult0 \*\tx7520\fs22\cf0\f0\charscalex100 {menghindari miskomunikasi antara ap
oteker dan pasien. }\tab \fs22\cf0\f0\charscalex100 {K}\fs22\cf0\f0\charscalex
100 {arena pasien sedang }\par\pard\li1626\ri0\sl-346\slmult0 \fs24\cf0\f0\cha
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{J1E108024 }\b0 \par\pard\li0\ri0\sl-373\slmult0 \fs24\cf0\f0\charscalex100\b {
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arscalex100\b {PROGRAM STUDI FARMASI }\b0 \par\pard\li2133\ri0\sl-253\slmult0 \f
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BUNG MANGKURAT }\b0 \par\pard\li4693\ri0\sl-266\slmult0 \fs24\cf0\f0\charscalex1
00\b {BANJARBARU }\b0 \par\pard\li5240\ri0\sl-253\slmult0 \fs24\cf0\f0\charscale
x100\b {2011 }\b0 \par\pard\sect\sectd\sbknone\pgwsxn12240\pghsxn15840\marglsxn6
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