Group name:

Anisa nurul hikmah

Diah ayu prambadini
Nila nurfadillah
Astri merlin
Sri wulan
Yulia indrianisa
A. DEFINITION

Asthma is an intermittent, reversible

obstructive airway disease in which the trachea
and brokhi respond in a hyperactive manner to a
particular stimulus (Smeltzer & Bare, 2002).

Asthma is a disease characterized by increased

tracheal and bronchial responses to various stimuli
by manifestation of wide airway narrowing and its
degree of alteration, either spontaneously or as a
result of treatment (Muttaqin, 2008).
Respiratory organs

a. Nose
Nose or naso or nasal is the first air channel, has two holes (rice
cavity), separated by nasal septum (septum rice).

b. Faring
The pharynx is a place of intersection between the respiratory
path and the food path, located beneath the base of the skull,
behind the nasal cavity, and the front mouth of the neck bone.
c. Larynx
The larynx or larynx is the airway and acts as a sound
formation, located in front of the pharynx to the height of the
cervical vertebra and into the trachea below it.

d. Trachea
The trachea or windpipe is a continuation of the larynx
formed by 16 to 20 rings consisting of horse-shaped bones
resembling a horse's hoop (letter C) inside is covered by a fluffy
mucous membrane called a ciliated cell, only moving outward .
e. Bronkus
Bronchus or throat branch is a continuation of the trachea,
there are 2 pieces that exist at the height of vertebra thoracic
vertebrae IV and V, have a structure similar to trachea and
coated by the same set type.

f. Lungs
The lungs are a body tool consisting mostly of bubbles (bubbles
of air or alveoli). This gelembug alveoli consists of epithelial and
endothelial cells. If the surface area is covered approximately 90
m².
Respiratory process
 Next...

Breathing (respiration) is an event of breathing

oxygen-enriched air from the outside and exhaling air
containing lots of carbon dioxide as residual oxidation out
of the body. This air sucking is called inspiration and
exhaling is called expiration. Thus, in the lungs an
exchange of intermediate oxygen is drawn and air enters
the blood and CO2 is removed from the blood by osmosis.
Then CO2 is released through the respiratory tract
(respiratory tract) and enters the body through the
pulmonary venous capillaries and then accumulates to the
left portico of the heart (atrium sinistra) to the aorta then
to the whole body (tissues and cells), here oxidation
( burning).
2. Respiratory system physiology
Oxygen in the body can be adjusted according to need.
Humans really need oxygen in their life, if not get oxygen for 4
minutes will cause damage to the brain that can not be repaired
lagidan can cause death. If the supply of oxygen diminishes will
cause chaos and mindcerebral anoxia.

a. Lung stroke
Lung breathing is the exchange of oxygen and carbon dioxide
that occur in the lungs. Breathing through the lungs or external
breathing, oxygen is taken through the mouth and nose when
breathing oxygen enters through the trachea to the alveoli
associated with blood in the pulmonary capillaries.
b. Cell respiration
 
Lung and tissue gas transport
 
The partial pressure difference between O2 and CO2 emphasizes
that the key of O2 flows from the alveoli into the tissue through
the blood, whereas CO2 flows from the tissues into the alveoli
through the blood vessels.
C. ETIOLOGY

To date the etiology of Bronchial Asthma is unknown. One

thing that stands out in people with asthma is the
phenomenon of bronchial hyperactivity. Bronchus asthma is
very sensitive to immunological stimulation and non
immunology.

D. PATHOPHYSIOLOGY

An Asthma attack is the result of a reversible diffuse

airway obstruction. Obstruction is caused by the emergence
of three main reactions namely contraction of smooth
muscles of the respiratory tract, membrane swelling lining the
bronchi, filling the bronchi with thick mucus. In addition, the
muscles of the bronchi and mucosa glands swell, thick
sputum, much produced and alveoli become hyperinflation,
with air trapped within the lung tissue. The resulting antibody
(IgE) then attacks the mast cells in the lung.
A. CLINIC MANIFESTATIONS

The usual symptoms of Asthma Bronchial are cough,

dyspnea, and wheezing. Attacks often occur at night. Asthma
usually begins suddenly with a cough and a sense of tightness
in the chest, accompanied by slow breathing, wheezing.
Expiration is always more difficult and longer than inspiration,
which encourages patients to sit upright and use every
accessory muscle of respiration. A blocked airway causes
dyspnea. Asthma attacks can last from 30 minutes to several
hours and may disappear spontaneously.
Nursing care
Sample case:
Nn.D complained of chest pain. After the assessment, the client said
chest pain on the right and left sounds ronkhi accompanied by cough with
phlegm, and the client said he has a history of asthma, allergic dust and
cold, never treated with Nebulizer tools and clients feel anxious because
of shortness of breath

I. ASSESSMENT
1. Identity
a. Patient identity
Name : Ms. D
Age : 19 years
Islam
Female gender
Status : Student
Education : Strata 1
Tribe of Nations : Indonesia
Address : Kutabumi Rt 08/02, Tangerang
MRS Date : June 15, 2017
Assessment Date : June 17, 2017
Medical diagnosis: Bronchial asthma
Main complaints : Chest pain
b. Identity of Responsible Person
Name : Ny. K
Age : 60 years
Hub.dengan patient : Parents
Occupation : Prosperity
Address : Kutabumi Rt 08/02, Tangerang

2. Health Status
a. Current health status
1. The main complaint (when the MRS and current)
• When MRS : Patients complain of chest pain
• Current : Patients are short of breath and cough with
phlegm

2. Reasons for hospital admission and travel now:

Because Patients complain of chest pain right and left,
Patients complain of shortness of breath, and accompanied
by cough with phlegm
3. Efforts made to overcome them

• Self-made efforts
"The patient said it was done by taking Orsiprenaline (
Alupent) medicine from a pharmacy"
• Efforts made by others
"Patient says assisted with Nebulizer tool“

b. Past health status

1. Diseases that have been experienced:
"Patients say they have asthma. Patients also said that
they had never had a serious illness and had no trauma or
accident. Patients have allergies to cigarette smoke, dust
and cold. If Patients inhale cigarette smoke then Patients
will experience the flu and attack shortness of breath “
2. Have been treated:
"The patient said he had been treated previously,
treated with a Nebulizer tool"

3. Allergies:
"Patients say have dust and cold allergy"

4. Habit (smoking / coffee / alcohol etc):

"There is no"
 
 
c. Family disease history (depict genogram)
Patients say who suffer from the same disease as the
patient, the sister of the patient's father (the same
patient's uncle) has this asthma disease. While the
family in the mother of the patient no one suffers from
asthma.
3. Pattern of basic needs (Data Bio-psycho-socio-cultural-
spiritual)
a. Pattern of Perception and Health Management

• Before illness :Patients said that in their daily life they

do not smoke and if they smell smoke the chest tightness,
the patient is not allergic to the type of drugs and food or
beverages but the patient there is dust and cold allergy,
and before the patient pain is very safe to dust and cold
both inside Outside the house, the patient always provides
a mask cover the nose and always use a protective coat
because patients understand the disease

• When sick :Patients say that if they get sick they will
buy Orsiprenaline (Alupent) medicine but the patient is
always more assisted by Nebulizer tool and the patient
says if after the patient gets sick avoided from cigarette
smoke, dust or dirt and cold temperatures that can lead to
the exposure of more serious diseases to patients
b. Pattern of Nutrition-Metabolic

• Before illness :
- Food intake: Patients say at the time before the usual
eating habits, good appetite, rice, vegetables and side
dishes. Frequency of eating 3x / day. Preferred foods are
ice, chocolate and fruit, because patients suffering from
asthma then the client has a taboo to eat in the form of
chocolate and ice food, foods containing preservatives
are limited.- Intake fluid: Patients 5-7 glasses a day,
water

• When sick :
- Food intake : Patients say since sick appetite
decreased not even want to eat, eat only porridge only
and can only spend ½ portion of food only. How to eat it
must be fed. So his weight decreased- Intake fluid:
Patient only drank 3-4 glass / day, water
c. Patterns of Activity and Exercise
1) Activity

• Before illness Patients say before the ill daily activity is

college, after college patients change clothes, eat and
sleep. At night the patient performs the task or study as
usual starting from 19:00 until 21:00 hours. And while
the student lecture take the time to travel with his
friends

• When sick Patients say that when sick the daily

activities are disturbed, not as usual and not able to
perform activities because it is difficult to breathe.
Patient's ability decreases so much need help to carry
out daily activities of patient assisted by family member
2) Exercise
• Before illness Patients say that patients often do
morning exercises with family, such as cycling together.
Every weekend also patients are often invited to his
family for recreation
• When sick Patients say when sick can not exercise
because the condition of his body that does not allow
because of shortness of breath

d. Sleep Patterns and Rest

• Before illness Patients say sleeping night 7-8 hours,
nap 1 hour, because patients do not feel shortness of
breath no problem
• When sick Patients say difficulty sleeping due to cough
that increases at night, patients say can not rest well,
patients often wake up at night, and patients sleep 2
hours night, nap 3 hours
e. Pattern Elimination

1) CHAPTER
• Before illness: Patients say before CHAPTER normal as
normal. Usually CHAPTER 2-3 x / day, in the morning and
evening, the color of yellowish feces and consistency of its
soft CHAPTER
• When sick: Patients say when the CHAPTER STD is still
normal as usual

2) BAK
• Before illness: Patients say before BAK illness is only 4-5x /
day. No difficulties experienced, clear urine color and typical
urine smell
• When sick: Patients say when the BAK disease is not normal
(decreased urine production) urine frequency 2-3x / day,
yellow color and typical urine smell
f. Pattern Roles and Responsibilities

• Before illnessPatients say good family relationships and

communicate well with family, patients can perform role
as the first child of Ny.K family and can act as good
student on campus and patient can very well be
responsible

• When sickPatients say they can not perform their role

as the first child of their family due to chest pain and the
patient can not communicate well if experiencing
shortness of breath, and not only as the first child of his
family but if the patient is sick the patient can not act well
as a student as usual

g. Pattern of Coupling and Stress Tolerance

• Before illnessPatients say before the illness if there is a

problem always discussed with his family, patient
behavior and strategy discipline was used by the patient
very well and the absence of other drug use before the
• When sick : Patient when sick if there is a problem of patients
experiencing stress, causing chest pain relapse asthma patients
and the use of drugs Orsiprenalin (Alupent) or with tools
Nebulizerh.

H. Cognitive Patterns and Perceptions

• Before illnessPatients assume no disturbance to the body, the

patient before the pain of understanding and adaptability with
around the patient is very good, the patient is very well
understood about his asthma disease, the patient also change his
perception from bad to good perception so it can be prevented to
experience (relapse) patient asthma

• When sickPatients say the perceptual pattern is disturbed but

the patient is very understanding about his asthma disease and
the patient assumes that the pain in his pain is the ordeal, the
patient receives the illness but the patient still tries to heal, hopes
to recover and can run his activity normally
i. Self Concept Patterns

• Before illnessBefore the illness of the patient can

describe the identity of his role in the family as well as on
his campus and self-concept in the patient that the
patient should always find out the knowledge of asthma
suffered so that it can be prevented by the knowledge or
information already obtained by the patient and the
patient feel comfortable when sick, and the patient
implements in his daily life of his knowledge or
information

• When sickPatients say when the illness continues to run

on his self-concept and patient's self-esteem is good
because patients while ill continue to implement it from
the knowledge or information that patients get that
asthma can be cured by maintaining the condition by way
of knowledge or information that patients can be well
j. Sexual Reproduction Patterns

• Before illness Patients say not married, female patients,

menstrual phase of patients fluently and right on the
date of each month and patients understand the
education of maintaining health on reproduction

• When sick : Patients say not married, female patients

and menstrual phase of patients fluently and right on the
date of each month and patients understand the
education of maintaining health on reproduction k.
Patterns of Values and Confidence

• Before illness Patients always perform their duty as

Muslims (pray 5 time). The patient believes that his
illness can be cured by believing in God

• When sick : Patients perform prayers 3-4 times and

always pray to God about the pain he suffered
4. Physical Assessment
a.General situation : level of consciousness:
Composmetis / apatis / somnolen / sopor / koma

GCS: Verbal: 6 Psychomotor: 5 Eyes: 4 b.

Vital sign :
Nadi: 76x / min
Temperature: 35.8oC
TD: 100/60 mmHg
RR: 28x / min

Physical state :
1) The state of hair and head Inspection: simestris, no fall,
flat hair distribution, no lesions, oval head shape Palpation:
no lumps / swelling, bushy hair and strong / not fragile

2) Face Preparation Inspection: same color with other

body parts, not pale, simestris Palpation: no tenderness
and edema
3) Eye examination Inspection : left and right eye
symmetry, left eyeball symmetry right, isokor pupil

4) Ear Examination Inspection : symmetrical shape

and position, good skin integrity, same color with other
skin, no liquids Palpation: no tenderness in the ear  

5) Nose Check Inspection : symmetrical nose

shape, there is still nasal hair, the use of the nostrils

6) Examination of the mouth and throat Inspection : no

enlarged tonsils, dry mouth mucosa, tongue is not dirty,
teeth are not caries, and the ceiling is clean.

7) Neck Examination Inspection : no jugular vein

distention Palpation: no enlargement of the thyroid gland
8) Examination of the Chest (lung, heart)
Auscultation : ronkhi sounds in both lungs
Palpation : when palpation tactile fremitus can feel
heavy vibration
Percussion : deaf, indicating a secret buildup
Inspection : ictus cordis, symmetrical chest, right
and left chest movements equal to breathing

9) Abdomen
Inspection : no stomach ascites, no lesions
Auscultation : Bowel sounds 12x / minute
Palpation : no tenderness in 4 quadrants
Percussion : sound of a tympanic sound

10) Upper extremities

Inspection : an infusion on the right hand and no
toes, no cyanosis
Muscle strength : still good (able to withstand the
pressure given)
11) Lower limb
Inspection : fingernails clean, no toes, no cyanosis
Muscle strength : still good (able to withstand the
pressure given)

12) Genetalia
- State of labia majora and minora: clean, no secret.
 5. Analysis Data
A. Data Analysis Table
No Dx Syntom Etiologi Problem
00032 DS : Breath Road Ineffectiveness of
- The client says chest pain Obstruction: Road Breath Clearing
is right and left - Foreign body in the
airway
- Clients complain of
- Restrained
shortness of breath secretions
- Client says he has cough Physiological:
accompanied by phlegm - Asthma
- Clients say dust and cold - Allergic airway
allergy
DO :
Vital sign :
TD: 100/60 mmHg
RR: 28x / min
- The client seemed to
gasp while breathing.
- Ronkhi breath
- The client appears to be
holding back pain
00002 DS: Less intake of Nutrition
- Clients say decreased eating imbalance: less
appetite than body needs
- Clients say eating out
½ servings
 
DO:
- BB / TB 43 kg / 155 cm
- Client seems weak - Eat
out ½ portion

00158 DS: Self-preparedness Readiness to

- Clients say want to improve coping
increase knowledge to
cope with stress
- Clients find out about
asthma
DO:
- Clients seem
anxious and
stressed
- The client
appears to indicate
his desire to
increase
knowledge to cope
with stress
- Client seems to
improve itself to
environmental
changes
Nursing Diagnosis / Collaborative Issues by Priority

1. Ineffective airway clearance associated with Breathing Road

Obstruction: Foreign body in the airway, Stressed secretions and
Physiological: Asthma, Allergic airway
2. Nutrition imbalance: less than body needs associated with less
food intake
3. Readiness to improve coping associated
with Readiness
NOC:
After a 3x24 hour nursing action is expected the patient's
airway hygiene is resolved with indicators:
After a 3x24 hour nursing action is expected to meet the needs
of the patient's nutritional needs with indicators:
After a 3x24 hour nursing action is expected to increase the patient's
koping readiness with indicators:
1. NIC:
Ineffectiveness of Road Bleeding \
Road Breathing Management:

1. Perform chest physiotherapy, with deep breathing relaxation

Rational: to help the airway get better

2. Dispose of the secret by motivating the patient to cough or

suck lenders
Rational: to open and smoothen the patient's airway

3. Advise how to be able to perform an effective cough

Rational: In order for the patient to relieve the cough

4. Auscultation of breath sounds, note areas where ventilation

is decreased or absent and the presence of additional sound
Rational: To know the abnormal breath sounds in the patient

5. Position semi fowler

Rational: to ease the patient's shortness of breath
1. Respiratory Monitor:
1. Monitor additional breath sounds
Rational: To know the patient's additional breath sound

2. Monitor patient's coughing ability

Rational: To know the patient's coughing ability

3. Record the turnover, characteristics and duration of cough

Rational: to know the duration of cough

4. Monitor patient's respiratory secretions

Rational: to know the breathing of normal patients or not

5. Monitor patient's shortness of breath, including activities

that increase or worsen the shortness of breath
Rational: to know the symptoms of shortness of breath to
improve good breathing
1. Management of asthma pathway
1. Compare the current status with the previous status to
detect changes in respiratory status
Rational: to detect changes in respiratory status

2. Monitor the reaction of asthma

Rational: to monitor the reaction of asthma
 
Allergy management
1. Recognize known allergies (eg, drugs, food, insects,
environment) and unusual reactions
Rational: to avoid allergies that occur during asthma

2. Notify health providers and health workers about known

allergies
Rational: in order to avoid mistake of drug administration

3. Instruct the patient how to treat respiratory problems

related to exposure of the ingredients that make the allergy
Rational: so that patients avoid exposure that makes allergies
Nutrition Imbalance: Less than Body Needs
Nutrition management:

1. Determine the patient's nutritional status and ability [of

patients] to meet nutritional needs
Rational: Helps patients get nutrients as needed

2. Look for [any] food allergies that the patient has

Rational: In order to know the existence of food allergies that are
owned by the patient and can increase the appetite of patients
by meeting the nutritional needs

3. Determine the number of calories and types of nutrients

needed to meet nutritional requirements
Rational: To provide food intake to patients as often as possible
Weight gain help:
1. If necessary do a diagnostic check to determine the cause of
weight loss
Rational: To know the cause of weight loss

2. Monitor daily caloric intake

Rational: To monitor the patient's calorie intake
 
3. Support increased caloric intake
Rational: In order for the patient is motivated to improve calorie
intake

Preparedness Increase Koping

Increased Koping
1. Help the patient in checking the available resources to meet
his goals
Rational: to be helped to meet its objectives
2. Provide real-life information on diagnosis, treatment, and
prognosis
Rational: to be able to know the real information

3. Find a way to understand the patient's perspective on stressful

situations
Rational: so that the patient does not feel stressed

Increased Self Efficacy

1. Examine barriers to changing behavior
Rational: to change the behavioral barriers to the patient

2. Provide information on the desired behavior

Rational: to let the patient know the desired behavior information

3. Help individuals to commit to action plans to change behavior

Rational: for patients to have a commitment and a goal to change
behavior

Counseling
1. Build a therapeutic relationship based on mutual trust and mutual
respect
Rational: to establish a relationship of mutual trust and mutual
2. Help the patient to find a problem or situation that causes
distress
Rational: to calm and overcome situations that cause distress

3. Ask the patient to look for what they can / can not do related
to the events that occurred
Rational: to know to do related to perristiwa that happened

 Muscle relaxation
1. Monitor the indicator of the absence of relaxed conditions,
such as movement, difficult breathing, difficulty breathing,
speech, and cough. Rational: to know the respiratory problems of
the patient

2. Encourage the patient to breathe deeply and slowly and

exhale (release) tension
Rational: to provide relaxation

3. Develop a personalized relaxation pattern that keeps the

patient focused and comfortable
Rational: to make the patient feel comfortable
Increased self-awareness
1. Share your observations or thoughts about patient behavior or
responses
Rational: to know the behavior or response of the patient

2. Help the patient to identify the impact of the disease on self-

concept Rational: to know the impact of disease on self-concept

3. Help the patient to identify an anxious situation

Rational: to know the patient's anxiety situation

Anxiety reduction
1. Use a calm and convincing approach
Rational: to be patient calm and confident to the nurse

2. Identify when anxiety level changes occur

Rational: to know the development of changes in anxiety levels

3. Instruct the patient to use relaxation techniques

Rational: for patients to do relaxation techniques independently
Facilitation of learning
1. Provide information in an appropriate manner, such as from
[things] to the more complex [information], from the knowing
first, from concrete information to abstract information
Rational: so that patients can understand the information
appropriately

2. Make the difference between the material that is important to

know and the material you want to know
Rational: to realize the purpose of the difference between the
important material to know and the material to be known and
to know what material is important to know by the patient and
what material the patient wants to know

3. Immediate correction, if the patient misinterprets the

information Rational: to let the patient know the real
information 4. Show the behavior that supports the patient
Rational: to make the patient feel comfortable
Implementation:
Ineffectiveness of Road Bleeding
Road Breathing Management:
1. Perform chest physiotherapy, with deep breathing relaxation
Response results: patients are willing to do chest
physiotherapy

2. Dispose of the secret by motivating the patient to cough or

suck lenders
Response results: the patient is able to issue a secret easily
Advise how to be able to perform effective cough Response
results: the patient is able to follow what the nurse

3. advises to do an effective cough

Response results: sounds ronkhi voice Positioning semi-fowler
to relieve shortness of breath

4. Consulting breath sounds, note down areas where

ventilation is decreased or absent and the presence of
additional sounds
Response results: the patient feels comfortable and does not
feel short of breath
Respiratory Monitor:
1. Monitor patient's coughing ability
Response results: patients can secrete secretions

2. Note the characteristics and duration of cough

Response results: know the characteristics and duration of the
patient's cough

3. Monitor patient's respiratory secretions

Response results: the patient is willing to be monitored for
respiratory secretions
 
Management of asthma pathway
1. Compare the current status with the previous status to
detect changes in the respiratory status
Response results: facilitate patient documentation

2. Monitor asthma reactions

Response results: there is an extrinsic sign (allergic)
Allergy management
1. Recognize known allergies (eg, drugs, food, insects,
environment) and unusual reactions
Response results: avoid allergies that will occur

2. Notify health providers and health workers about known

allergies
Response results: avoid the occurrence of errors in drug
administration

3. Show the patient how to treat respiratory problems

related to exposure of the ingredients that make the allergy
Response results: the patient is spared from exposure that
makes the allergy
 
Nutrition imbalance: less than body needs
Nutrition management:
1. Determine the patient's nutritional status and ability [of
patients] to meet nutritional needs
Response result: patient's nutritional status and patient's
ability to meet nutritional needs can be resolved
2. Identify allergy or intolerance of the patient's food
Response results: there is an allergy in the patient

3. Determine the number of calories and types of nutrients

needed to meet nutritional requirements
Response results: the number of calories and types of
nutrients meets the nutritional requirements

Weight gain help:

1. If necessary do a diagnostic check to determine the
cause of weight loss
Response results: causes weight loss patients karna feel
chest pain
2. Monitor daily caloric intake
Response results: can meet the caloric intake
 
3. Supports increased caloric intake
Response results: patients are optimistic for increased caloric
intake

4. Instruct ways to increase your caloric intake

Response results: the patient follows the instructions already
given to increase the caloric intake

Readiness to Increase Koping

Increased Koping:

1. Assist the patient in checking the available resources to

meet his goals
Response results: the patient is assisted in checking the
sources to meet the objectives

2. Provide actual information on diagnosis, treatment, and

prognosis
Response results: patients get actual information
4. Support the patient to identify the strength and ability of
self
Response of results: patients get support to identify self-
strength and ability

Increased Self Efficacy

1. Identify barriers to changing behavior
Response results: the patient experiences behavioral
barriers

2. Provide information on the desired behavior

Response results: patients get information about behavior
that behavior

3. Assist individuals to commit to action plans to change

behavior
Response results: the patient is helped to commit to action
plans to change behavior
Counseling
1. Building a therapeutic relationship based on mutual trust
and mutual respect
Response result: patient more mutual trust and respect

2. Help the patient to identify the problem or situation that

causes distress
Response results: the patient helps to identify the problem
or situation that causes distress

3. Ask the patient to identify what they can / can not do with
the event
Response results: patients can do related to the events that
occur

Muscle relaxation
1. Monitor the indicator of the absence of relaxed conditions,
such as movement, difficulty breathing, difficult breath,
speech, and cough.
Response results: found no pegging problems, difficult
breathing
2. Instruct the patient to breathe deeply and slowly and
exhale [release] tension
Response results: the patient feels more relaxed after
following the instructions of the nurse

Increased self-awareness
1.Divide the observations or thoughts about the patient's
behavior or response
Response results: after the observation the patient feels
better than before

2.Helping the patient to identify the impact of the disease on

self-concept
Response results: patients are helped to identify the impact
of self-concept illness

3.Help the patient to identify anxious situation

Response results: patients feel helped to be more relaxed

Anxiety reduction
1.Using a calm and convincing approach
Response results: in order to reduce anxiety in patients
2.Identify in the event of anxiety level changes
Response results: know the occurrence of anxiety level
changes

3.Meintruksikan patient to use relaxation techniques

Response results: patients can follow using relaxation
techniques

Facilitation of learning

Provide information in a precise way, such as from [simple]

things to the [more] complex from the knowing [first], from
concrete information [to] abstract [information]
Response results: the patient can understand what is
informed appropriately
Make a difference between the material that is important to
know and the material you want to know
Response of results: knowing the difference which material is
important to know and which material you want to know
Immediate correction, if the patient misinterprets the
information
Response of results: no errors in interpretation of information
Evaluation
S: Patients say right and left chest pain is decreased,
nausea at mealtime decreases, patients say anxiety
decreases
O: Shortness of breath of the patient has been visibly
reduced, the patient is seen to spend his food and
allergies appear diminished patients, the patient's
anxiety seemed overcome
A: Partial terasi problem
P: Continue the next intervention
1. Position a semi-fowler patient sleep if the patient
feels tight, advise the patient to limit his activity
2. Instruct the patient to eat less but as often as
possible
3. Encourage the patient to improve behavior readiness
by increasing coping