Mitra Husada Health Internasional Conference (MIHHICo)

INTEGRATED EXCELLENT MATERNITY NURSING CARE FOR LOW -BIRTH-WEIGHT INFANT AT SANTI MEILALA INPATIENT PRIMARY CLINIC MEDAN POLONIA DISTRICT, NORTH SUMATRA PROVINCE IN 2025

Thu, 14 Aug 2025 00:00:00 +0700

According to the World Health Organization (WHO, 2021), low birth weight (LBW) refers to infants who weigh less than 2,500 grams at birth. Meanwhile, Juriyah et al. (2024) state that LBW occurs from birth up to the first 24 hours after delivery. Infants with low birth weight are more susceptible to infectious diseases and frequently experience complications that may lead to death, as their organs are not yet fully developed. In Indonesia, several factors increase the risk of LBW, including maternal age under 20 or over 35 years, short intervals between pregnancies, a history of delivering LBW infants, strenuous physical labor, working without adequate rest, extreme poverty, underweight and poor nutritional status, smoking habits, alcohol consumption, anemia, preeclampsia or hypertension, infections during pregnancy, multiple pregnancies, congenital abnormalities in the baby, and infections related to pregnancy.

MANAGEMENT OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) NURSING CARE BASED ON SDGs AND WHO IN MR. H AT RSUP H. ADAM MALIK MEDAN IN 2025

Thu, 14 Aug 2025 00:00:00 +0700

Penyakit Paru Obstruktif Kronis (PPOK) adalah gangguan pernapasan progresif dan ireversibel yang ditandai dengan keterbatasan aliran udara yang persisten dan secara signifikan memengaruhi status fungsional dan kualitas hidup pasien. Meskipun sifatnya tidak dapat disembuhkan, PPOK dapat dikelola secara efektif melalui intervensi medis dan keperawatan yang komprehensif dan berkelanjutan. Studi kasus ini bertujuan untuk mengimplementasikan dan mengevaluasi perawatan keperawatan medis-bedah yang diberikan kepada Bapak H, seorang pasien yang didiagnosis PPOK di Rumah Sakit Umum H. Adam Malik. Metode studi kasus deskriptif digunakan untuk mengeksplorasi penerapan proses keperawatan, yang meliputi asesmen, diagnosis keperawatan, perencanaan intervensi, implementasi, dan evaluasi. Selama fase asesmen, data penting dikumpulkan melalui wawancara dan pemeriksaan fisik, yang mengungkapkan gejala utama seperti sesak napas, laju pernapasan abnormal, penggunaan otot bantu pernapasan, dan penurunan saturasi oksigen. Berdasarkan temuan ini, tiga diagnosis keperawatan prioritas ditetapkan: bersihan jalan napas tidak efektif, pola pernapasan tidak efektif, dan intoleransi aktivitas. Intervensi keperawatan yang direncanakan dikembangkan sesuai dengan Standar Intervensi Keperawatan Indonesia (SIKI) 2017, yang berfokus pada manajemen jalan napas, dukungan pernapasan, dan peningkatan toleransi aktivitas. Intervensi ini diimplementasikan selama periode tiga hari dan didokumentasikan secara menyeluruh. Proses evaluasi menggunakan pendekatan SOAP dan menunjukkan penyelesaian sebagian dari semua masalah keperawatan yang teridentifikasi, dengan peningkatan yang nyata pada status pernapasan pasien. Namun, perawatan keperawatan berkelanjutan dan edukasi pasien sangat penting untuk mempertahankan kemajuan dan mencegah komplikasi lebih lanjut. Temuan studi ini menggarisbawahi peran penting perawatan keperawatan profesional dalam mengelola PPOK dan menekankan pentingnya pendekatan sistematis dalam meningkatkan hasil klinis dan kualitas hidup pasien.

CONTINUITY OF MIDWIFERY CARE FOR MRS. T WITH BREAST ENGORGEMENT AT YUNAJI SRI REZEKI INDEPENDENT MIDWIFERY PRACTICE, MEDAN TEMBUNG DISTRICT, DELI SERDANG REGENCY NORTH SUMATRA, YEAR 2025

Thu, 14 Aug 2025 00:00:00 +0700

Maternal Mortality Rate (MMR) and Infant Mortality Rate (AKB) are important indicators in describing the welfare of a country's society. The high number of maternal deaths during pregnancy, childbirth, and postpartum periods, including those caused by accidents or falls, shows a major problem in Indonesia in this regard. Development in the health sector focuses on improving community welfare. The Sustainable Development Goals (SDGs) continue the Millennium Development Goals (MDGs) agenda through 2030, to follow up on the MDGs and achieve 169 targets by 2023 (Ministry of Health of the Republic of Indonesia, 2021). The results of a survey conducted among PMB midwives in December-February 2024/2025 indicate that 60 maternity mothers were recorded. In December-February 2024/2025, 20 postpartum mothers visited the Yunaji Midwife Clinic for postpartum follow-up. During the visit, there were 10 postpartum mothers; one of them was 1 experiencing breast milk dams due to breastfeeding that was not continuously, the baby has not breastfed properly, the breastfeeding position is not correct, abnormalities in the nipples, the use of BH is too tight, and during pregnancy the mother does not do breast care or the mother's lack of knowledge about breast care From the results of the research survey obtained from 10 postpartum mothers, including 1 postpartum mother who experienced a breast milk dam, so the author carried out midwifery care for Mrs. T at the age of 38 years postpartum 6 days ago P4A0 with a breast dam. The purpose of the care is to anticipate complications in the mother and baby, as well as problems that can be addressed through breast care for Mrs. T at PMB Yunaji, Kec.Medan Tembung Regency, Deli Serdang, North Sumatra 2024.

MANAGEMENT OF EMERGENCY NURSING CARE WITH SERVICE EXCELLENT FOR MR. J FOLLOWING TOTAL THYROIDECTOMI IN THE POST-SURGICAL INTENSIVE CARE UNIT AT H. ADAM MALIK CENTRAL GENERAL HOSPITAL MEDAN 2025

Thu, 14 Aug 2025 00:00:00 +0700

ABSTRACT

Background: Thyroid cancer is one of the most common non-communicable diseases, with a steadily increasing prevalence both globally and nationally. The standard treatment for this condition often involves total thyroidectomy as a definitive therapeutic procedure. Postoperative patients require intensive nursing care, especially during the critical phase in the ICU. Objective: This scientific paper aims to describe the management of emergency nursing care with a service excellence approach for Mr. J, a post-total thyroidectomy patients in the Post-Surgical ICU of H. Adam Malik General Hospital, Medan. Method: A descriptive method was employed using a case study approach through interviews, observations, and nursing documentation review. Subject: The subject of this study was a single patients diagnosed with post-total thyroidectomy due to thyroid cancer who received ICU care. Result: The assessment revealed key problems, including impaired gas exchange, ineffective airway clearance, and ventilator weaning difficulties. The nursing intervations focused on airway management, mechanical ventilation monitoring, and appropriate weaning strategis. The interventions were implemented over three days with close monitoring and multidisciplinary collaboration. The evaluation showed improvements in breathing patterns, reduced abnormal breath sound, and increased oxygen saturation. Conclusion: This scientific paper highligts the impotence of applying service excellence principles in critical care nursing to enhance the quality of care, patients safety, and comfort for post-surgical patients.

CONTINUOUS MIDWIFERY CARE (CONTINUITY OF CARE) IN MRS. T, AGE 25 YEARS OLD, WITH PERINEAL RUPTURE DEGREE I AT PRATAMA VINA CLINIC, MEDAN CITY, YEAR 2025

Wed, 07 Jan 2026 00:00:00 +0700

ABSTRACT

A perineal rupture is a tear (laceration) that occurs in the perineum, the area between the vagina and the anus. This tear can occur spontaneously during labor, especially if the baby's head comes out too quickly, or it can be caused by the use of assistive devices such as a vacuum or forceps. Lacerations usually occur in the middle of the perineum and can extend to the surrounding tissue depending on the speed, size of the baby's head, and the elasticity of the perineal tissue. This study aims to provide useful information in efforts to prevent and treat perineal rupture, as well as contribute to improving the quality of maternal health services.

THE RELATIONSHIP BETWEEN IEC FAMILY SERVICES AND IMPROVING ABILITY AND INTEREST IN BECOME A FAMILY ACCEPTOR IN THE WORKING AREA OF LAMPAHAN PUBLIC HEALTH CENTER, TIMANG GAJAH DISTRICT, BENER MERIAH REGENCY, ACEH PROVINCE IN 2023

Thu, 14 Aug 2025 00:00:00 +0700

Background: Based on a preliminary survey conducted in the Working Area of the Lampahan Health Center, Timang Gajah District, Bener Meriah Regency in 2023, it was found that the number of women of childbearing age was 3161 people and 2,495 KB acceptors (79%), a survey of 10 KB acceptors. using KB Injections as many as 3 people (30%), Pills 3 people (30%), IUD 2 people (20%), Implants 2 people (20%). Contap 1 person (10%) and Condoms 2 people (20%), with the number of children 2-3 people. with an average job of housewives, stated that the desire to use contraceptives was due to their own will and according to the midwife the type of contraception that can be used, from the preliminary survey it was found that there were still few who used long-term contraception, because acceptors felt they were not ready and were afraid to use long-term contraception. Method: This study is an observational/survey study, where data is collected from respondents using questionnaires without any intervention on the research subjects. The population of this study is 165 family planning acceptors in the working area of the Lampahan Community Health Center, Timang Bajah District, Bener Meriah Regency, Aceh Province in 2023. The sampling method was determined by purposive sampling and the Slovin formula with a margin of error of 5% or 0.05. The data analysis method used is Chi-square. Result : There is a relationship between educational information communication and the ability and interest of KB acceptors seen from the age of the Lampahan Health Center Working Area, Timang Gajah District, Bener Meriah Regency, Aceh Province in 2023 where the p-value is 0.036 for communication, 0.033 for information and 0.036 for education (p <0.05). There is a Relationship between Communication and Education Information and the Ability and Interest of KB Acceptors as seen from the number of children in the Working Area of the Lampahan Health Center, Timang Gajah District, Bener Meriah Regency, Aceh Province in 2023 where the p-value is 0.012 for communication and education and 0.011 for information (p <0.05). There is a Relationship between Communication of Educational Information and the Ability and Interest of KB Acceptors as Seen from the History of Diseases in the Working Area of the Lampahan Health Center, Timang Gajah District, Bener Meriah Regency, Aceh Province in 2023 where the p-value is 0.001 for communication and education and 0.021 for information (p<0.05).

THE INFLUENCE OF PARENTING PATTERNS ON TANTRUM INCIDENTS IN TODDLERS IN THE WORKING AREA OF THE LABUHAN RUKU COMMUNITY HEALTH CENTER, TALAWI DISTRICT, BATUBARA REGENCY IN 2022

Thu, 14 Aug 2025 00:00:00 +0700

Background: This study investigates the influence of parenting styles on tantrum incidence among toddlers in the work area of Labuhan Ruku Public Health Center. Using a descriptive-analytic method with a cross-sectional design, the study involved 40 respondents. The results indicate that neglectful parenting was the most prevalent style, while distress tantrums were the most common type. A significant association (p = 0.005) was found between parenting styles and tantrum types. These findings highlight the need for parenting interventions to reduce tantrum behavior in toddlers.

THE EFFECT OF ABDOMINAL STRETCHING EXERCISES ON REDUCING DYSMENORRHEA PAIN IN ADOLESCENTS IN PERTUMBUKAN VILLAGE WAMPU SUBDISTRICT LANGKAT REGENCY NORTH SUMATERA PROVINCE IN 2024

Wed, 07 Jan 2026 00:00:00 +0700

ABSTRACT
Introduction: Quality of life for adolescents is a positive assessment within the life cycle, reflected in their satisfaction with themselves, particularly in terms of both physical and psychosocial health, including a positive self-image. Reproductive health in women is an essential component, as the female reproductive system is susceptible to various disorders that may lead to reproductive health problems. One of the most common reproductive health issues is dysmenorrhea, which can significantly affect quality of life, daily activities, and academic performance. Objective: to analyze the effect of abdominal stretching exercises on reducing dysmenorrhea pain in adolescents in Pertumbukan Village, Wampu Subdistrict, Langkat Regency, North Sumatra Province in 2024. Method: This research is a quantitative study using a quasi-experimental design with a non-equivalent control group design. The approach applied was the two-group pretest and posttest method. The sampling technique used was non-probability sampling with purposive sampling. Results: showed that the group given abdominal stretching exercises experienced a significant reduction in dysmenorrhea pain (p-value = 0.00), while the group that did not receive the intervention had no significant change (p-value = 0.1000). Conclusion: Based on these findings, it can be concluded that abdominal stretching exercises have a significant effect on reducing dysmenorrhea pain in adolescents in Pertumbukan Village, Wampu Subdistrict, Langkat Regency, North Sumatra Province, in 2024.

SERVICE EXCELLENT” MEDICAL SURGICAL NURSING MANAGEMENT OF Mr. M WITH PLEURA EFUSION AT H. ADAM MALIK MEDAN HOSPITAL NORTH SUMATERA PROVINCE YEAR 2025

Wed, 07 Jan 2026 00:00:00 +0700

Pleural effusion is a condition where fluid accumulates in the pleural lining of the lungs. This fluid can be either transudate or exudate, depending on the cause. This condition occurs when the body is unable to reabsorb the fluid. Some of the contributing factors include increased pressure in the subpleural capillaries or lymphatic vessels, increased capillary wall permeability, low blood plasma oncotic pressure, increased negative pressure in the pleural cavity, and impaired lymphatic drainage function. More permeable capillary walls allow fluid to escape easily, plus low levels of plasma protein that reduce the ability of blood to retain fluid, causing the lymphatic system to not be optimal in draining fluid from the pleural cavity. Based on WHO data (2021), the global prevalence of pleural effusion reached 37.5% or 828,136 cases. Of this number, 14.1% (116,792 cases) were caused by lung disease, 11.4% (94,420 cases) by pneumonia infection, 8.5% (70,391 cases) by heart failure, and 5.5% (45,547 cases) by cirrhosis hepatis. In Indonesia, according to the , the prevalence of pleural effusion reached 2.7% or around 1.39 million people. In North Sumatra Province, based on data from the Health Office (2021), the incidence rate has increased every year: 1.2% in 2019, rising to 1.5% in 2020, and 2.7% in 2021, with a total of 139 cases. At Haji Adam Malik General Hospital, there were 273 patients with pleural effusion in 2020.(Feni Fitriani, 2021)(Chairman Guideline Committee, 2022)(Supriantarini & Afifah, 2025)(Habas et al., 2024)

MANAGEMENT OF MENTAL NURSING CARE WITH SERVICE EXCELLENCE FOR Mr. M WITH LOW SELF-ESTEEM AT PROF. DR. MUHAMMAD ILDREM MENTAL HOSPITAL MEDAN

Wed, 07 Jan 2026 00:00:00 +0700

ABSTRACT

Mental health is an essential aspect of an individual's life, encompassing mental, emotional, and social well-being. One common disorder observed in patients with mental illness is low self-esteem, which can affect their social, psychological, and emotional functioning. Schizophrenia is a severe mental disorder characterized by symptoms such as hallucinations, delusions, and affective disturbances, often accompanied by low self-esteem. This study aims to examine the management of psychiatric nursing care using a service excellence approach for Mr. M, a patient experiencing low self-esteem at Prof. Dr. Muhammad Ildrem Mental Hospital in North Sumatra Province, in the year 2025. This research employs a case study approach based on the six stages of the nursing process: assessment, diagnosis, planning, implementation, evaluation, and documentation. The primary focus is on applying the principles of service excellence in providing nursing care to patients with low self-esteem. Through the service excellence approach, the nursing student was able to conduct a comprehensive assessment, establish an accurate nursing diagnosis, plan individualized interventions, carry out nursing actions according to the patient’s needs, and perform proper evaluation and documentation. Nursing care delivered professionally and humanely has proven effective in gradually improving the patient's self-esteem. The service excellence approach in managing psychiatric nursing care for patients with low self-esteem has been proven effective in enhancing the patient's psychosocial condition. This study is expected to contribute to improving the quality of mental health nursing services, particularlyat Prof. Dr. Muhammad Ildrem Mental Hospital.

THE RELATIONSHIP BETWEEN FAMILY SUPPORT, COPING MECHANISMS AND ANXIETY IN INFERTILE MOTHERS

Thu, 14 Aug 2025 00:00:00 +0700

ABSTRAK

Sekitar 10–15% dari 39,8 juta pasangan subur di Indonesia mengalami masalah infertilitas. Akibatnya, diperkirakan 4 hingga 6 juta pasangan membutuhkan perawatan untuk membantu mereka memiliki anak. 74,6% wanita infertil melaporkan mengalami perubahan suasana hati, merasa tidak berdaya karena lamanya infertilitas yang mereka alami. Penelitian ini bertujuan untuk mengetahui apakah ada hubungan antara dukungan suami dan mekanisme koping dengan tingkat stres pada ibu infertil di Klinik Varia Medika. Penelitian ini menggunakan desain kuantitatif, cross-sectional. Populasi dalam penelitian ini adalah seluruh pasangan infertil di Klinik Varia Medika pada tahun 2024, dengan sampel yang diambil melalui teknik purposive sampling sebanyak 52 responden. Data dikumpulkan menggunakan kuesioner yang telah diuji validitas dan reliabilitasnya. Berdasarkan hasil penelitian, secara statistik, terdapat hubungan antara mekanisme koping dan kecemasan (p = 0,000). Uji chi-square di SPSS menghasilkan nilai p sebesar 0,008 (α = 0,05), yang menunjukkan adanya hubungan signifikan antara dukungan keluarga dan tingkat stres pada wanita yang mengalami infertilitas.

CONTRACEPTIVES AND THE INCIDENCE OF VAGINAL DISCHARGE AMONG FAMILY PLANNING ACCEPTORS

Thu, 14 Aug 2025 00:00:00 +0700

Penggunaan kontrasepsi suntik hormonal diketahui memiliki efek samping, salah satunya adalah keputihan patologis (leukorea). Penelitian ini bertujuan untuk mengetahui hubungan antara penggunaan kontrasepsi suntik hormonal dan kejadian keputihan di kalangan penerima KB di Praktik Mandiri Bidan Rini Susi Safitri, Huta I Pematang Kerasaan, pada tahun 2024. Penelitian ini menggunakan metode analitik dengan desain cross-sectional. Populasi penelitian adalah seluruh penerima kontrasepsi suntik 1 bulan dan 3 bulan, berjumlah 41 responden, yang dipilih menggunakan purposive sampling. Data dikumpulkan menggunakan kuesioner dan dianalisis menggunakan metode univariat dan bivariat. Analisis bivariat menggunakan uji Chi-square dengan tingkat signifikansi 0,05. Hasil penelitian menunjukkan bahwa sebagian besar responden (68,3%) menggunakan kontrasepsi suntik 3 bulan, dan 58,5% mengalami keputihan. Uji Chi-square menunjukkan hubungan yang signifikan antara durasi penggunaan kontrasepsi dan kejadian keputihan (p = 0,005). Dapat disimpulkan bahwa penggunaan kontrasepsi suntik hormonal, terutama selama lebih dari satu tahun, secara signifikan berhubungan dengan terjadinya keputihan pada pengguna KB.

GERIATRIC NURSING CARE MANAGEMENT WITH SERVICE EXCELLENCE FOR MRS. N WITH POST-ISCHEMIC STROKE AT THE UPTD ELDERLY SOCIAL SERVICE BINJAI BINJAI CITY NORTH SUMATRA PROVINCE YEAR 2025

Thu, 14 Aug 2025 00:00:00 +0700

ABSTRACT
Stroke is a clinical condition characterized by impaired brain function. This disorder can cause death that lasts more than 24 hours, resulting in disability, loss of bodily functions, such as paralysis, and difficulty in communication. Stroke is also categorized as a neurological emergency that is of serious concern worldwide. Indonesia is the highest country in Asia. (Aulyra Familah et al., 2024) According to the World Health Organization in 2023 it says about 15 million people worldwide suffer from stroke and five million people experience permanent paralysis due to stroke. The most common stroke, ischemic type, accounts for 50-85% of all cases. Southeast Asia accounted for 4.4 million people suffering from stroke in 2020 and an estimated 7.6 million people died from stroke. (Amila, 2023) as stroke is a rapidly developing disease, characterized by local or global brain function disorders that cause death without a clear cause other than blood vessel blockage. The case study method set is a qualitative descriptive method through case studies. The results of the evaluation showed that the patient was able to undergo passive motion-prone movement exercises every day, was able to cough effectively and was able to practice speaking skills.

GERIATRIC NURSING CARE MANAGEMENT FOR Mr. E WITH HYPERTENSION AT THE ELDERLY SOCIAL SERVICE UNIT (UPTD) BINJAI CITY, NORTH SUMATRA PROVINCE

Thu, 14 Aug 2025 00:00:00 +0700

Hypertension is a chronic condition that cannot be cured but can be managed. The incidence of hypertension among older adults is increasing globally, including in Indonesia, due to aging processes and degeneration (Iqbal & Handayani, 2022). The general objective of this study is to implement nursing care management for patients with hypertension at the Social Elderly Care Unit (UPTD Pelayanan Lanjut Sosial) in Binjai City, North Sumatra Province, in 2025. The World Health Organization (WHO) estimates that the global prevalence of hypertension currently reaches 22% of the total world population. The African continent has the highest prevalence, at 27%, while the Southeast Asia region ranks third with a prevalence of 25% of the total population. Data from the Indonesian Ministry of Health in 2018 show that the prevalence of hypertension among the elderly is quite high, with details as follows: the age group 65–74 years is 55.2%, and those over 75 years old is 69.5% (Kusumo, 2021). The results of this study indicate that 34 out of 198 elderly individuals suffer from hypertension, showing a prevalence rate of 22%.
The 2023 Indonesian Health Survey (SKI) showed a decline in hypertension prevalence among those aged 18 years and older, with a prevalence rate of 30.8%. Based on the data obtained, the number of hypertension cases recorded in 2023 was 2,333 cases.
In North Sumatra Province, the prevalence of hypertension reached 6.7% of the total population. This means that approximately 12.42 million people suffer from hypertension, spread across various districts in the province.

The Relationship Between Maternal Anxiety and Early Management of Febrile Seizures in Children at RSUP Haji Adam Malik Medan

Thu, 08 Jan 2026 00:00:00 +0700

Adolescent girls are individuals who are vulnerable to suffering from anemia due to the menstrual period that occurs every month. In addition, factors suspected to be the cause of anemia in adolescent girls include poor nutritional intake patterns, worm infections, frequent drinking of tea or coffee after meals, prolonged sleep, vitamin C deficiency and economic factors. This study aims to determine the Relationship of Motivation with Compliance of Adolescent Girls in Consuming Fe Tablets at SMPN 1 Tuhemberua, Tuhemberua District, North Nias Regency, North Sumatra Province in 2023. This study is a study with a Cross-sectional design (sectional cut). The number of samples used was 42 people obtained using the Random sampling technique. The data analysis technique used chi-square analysis. The results obtained in this study from 42 respondents, based on a statistical test with a p-value of 0.004 (p-value <0.05), indicate a relationship between motivation and compliance of adolescent girls in consuming iron tablets at SMPN 1 Tuhemberua, Tuhemberua District, North Nias Regency, North Sumatra Province in 2023. It is recommended that health workers increase health promotion to adolescents to prevent anemia in adolescents.

FACTORS RELATED TO THE INCIDENCE OF LBW (LOW BIRTH WEIGHT) IN TANJUNG PURA REGIONAL HOSPITAL, TANJUNG PURA DISTRICT, LANGKAT REGENCY YEAR 2023

Thu, 14 Aug 2025 00:00:00 +0700

Birth weight is the baby's weight measured within the first hour after birth. It also helps assess growth and gestational age, as well as maturity. According to the WHO, low birth weight (LBW) is defined as a newborn weighing less than 2,500 grams. LBW can occur not only in premature babies but also in full-term babies who experience growth restriction during pregnancy.Purpose: To determine the factors associated with the incidence of low birth weight (LBW) at Tanjung Pura Regional Hospital in 2023. Population and sample: The case population was all mothers who gave birth to babies at Tanjung Pura Regional General Hospital in May-June 2023. Based on data obtained from medical records at Tanjung Pura Regional General Hospital in 2023, there were 39 people. Place and Time: inTanjung Pura Regional Hospital, Tanjung Pura District, Langkat Regency. Results : The results of statistical analysis using the chi square test stated that there was a relationship between maternal age and the incidence of LBW at Tanjung Pura Regional Hospital in 2023 with a p-value of 0.020 (p-value <0.05).Bivariate : The bivariate analysis in this study uses the chi-square test at a 95% confidence level to analyze the relationship between the independent variables and the dependent variable. If the analysis results show a significant relationship with a p-value <α (0.05), CONCLUSION : There is a relationship between maternal age and the incidence of LBW inTanjung Pura Regional Hospital in 2023.There is a relationship between maternal parity and the incidence of LBW in Tanjung Pura Regional Hospital in 2023.

"NURSING CARE MANAGEMENT OF MEDICAL-SURGICAL NURSING FOR MRS. E WITH ISCHEMIC STROKE IN ROOM RA1 AT H. ADAM MALIK MEDAN NORTH SUMATRA PROVINCE, YEAR 2025."

Thu, 14 Aug 2025 00:00:00 +0700

ABSTRACT

Ischemic stroke is the most common type of stroke, occurring due to a blockage in the blood vessels of the brain, which leads to reduced blood flow and oxygen supply to brain tissue. This condition causes rapid brain cell death and may result in neurological deficits such as paralysis, speech disorders, and loss of consciousness. Risk factors for ischemic stroke include hypertension, diabetes mellitus, dyslipidemia, heart disease, smoking habits, and an unhealthy lifestyle. Stroke is the second leading cause of death and a major cause of disability worldwide. According to the World Health Organization (WHO, 2022), stroke accounts for approximately 6 million deaths each year. About 62% of cases occur in individuals under the age of 70, and 16% occur between the ages of 15–49. In Indonesia, the prevalence of stroke is 8.3 per 1,000 population, while in North Sumatra Province, the incidence rate reaches 9.3%. At RSUP H. Adam Malik, the number of ischemic stroke cases continues to rise: 295 cases in 2023, 393 cases in 2024, and 131 cases in the first two months of 2025. In relation to this, the present study aims to obtain data on the problem of ischemic stroke at RSUP H. Adam Malik. Based on these findings, the researcher prese nts a case study of medical-surgical nursing care for Mr. E with ischemic stroke in the RA1 Ward at RSUP H. Adam Malik.

MATERNAL NURSING CARE MANAGEMENT WITH EXCELLENT SERVICE FOR MRS. J WITH MASTITIS AT PERA CLINIC, MEDAN TUNTUNGAN SUBDISTRICT, NORTH SUMATRA PROVINCE, IN 2025

Thu, 14 Aug 2025 00:00:00 +0700

Mastitis is an inflammation of the breast tissue that commonly occurs in breastfeeding mothers and can cause serious complications if not treated properly. This case study aims to evaluate the implementation of maternity nursing care management with a service excellent approach for Mrs. J who experienced mastitis at the Pera Clinic, Medan Tuntungan District, North Sumatra in 2025. The method used is a descriptive case study with a nursing process approach that includes five stages: assessment, diagnosis, intervention, implementation, and evaluation. The results of the assessment showed that Mrs. J experienced breast pain, fever, pus discharge from the nipple, and problems in breastfeeding due to mastitis. The established nursing diagnoses included acute pain, hyperthermia, and ineffective breastfeeding. The interventions provided focused on reducing pain, treating infections, and increasing the effectiveness of breastfeeding. The implementation of nursing care showed an improvement in the patient's physical and psychological condition. The application of the service excellent principle that prioritizes professionalism, empathy, and collaboration has been proven to improve the quality of nursing care. The conclusion of this study shows that comprehensive nursing care management oriented towards excellent service can have a positive impact on the healing of mastitis and patient comfort.

EXCELLENT GERONTIC NURSING CARE MANAGEMENT FOR MRS. S WITH GOUT ARTHRITIS AT THE UPTD SOCIAL SERVICES FOR THE ELDERLY

Thu, 14 Aug 2025 00:00:00 +0700

Gout arthritis is a form of inflammatory arthritis caused by the accumulation of uric acid crystals in the joints, commonly found in the elderly population. This condition results in severe pain, swelling, limited mobility, and significantly reduces the quality of life of those affected. This scientific paper is based on a case study of Mrs. S, a 76-year-old elderly woman residing at the Elderly Social Service Unit (UPTD) in Binjai, who has been suffering from gout arthritis for over seven years. The purpose of this study is to implement geriatric nursing care management using a service excellent approach, which prioritizes holistic, patient-centered care across biological, psychological, social, spiritual, and cultural aspects.The method used is a descriptive case study involving a comprehensive nursing care process, including assessment, nursing diagnosis, planning, intervention, implementation, and evaluation. Data collection was conducted through interviews, direct observation, physical examinations, and documentation in the social care facility. The initial assessment indicated that Mrs. S experienced severe knee pain, impaired mobility, discomfort, disrupted sleep, and compromised tissue integrity due to chronic inflammation.Various interventions were carried out based on the Indonesian Standard for Nursing Diagnosis (SDKI), Nursing Interventions (SIKI), and Nursing Outcomes (SLKI), complemented with non-pharmacological approaches such as warm compresses and relaxation techniques. After three days of intensive nursing care, the evaluation results showed significant improvement, including pain reduction, better sleep quality, increased mobility, and overall enhanced comfort.This study emphasizes the importance of service excellent-based nursing care in improving the quality of life of the elderly in social institutions. Applying excellent service standards—attitude, attention, action, competence, appearance, and responsibility—effectively fosters therapeutic relationships between nurses and clients, increases adherence to treatment, and supports the overall well-being of elderly individuals. Through this holistic approach, geriatric nursing management not only addresses basic elderly needs but also empowers them to feel valued and content in their later years.

GERIATRIC NURSING CARE MANAGEMENT WITH A SERVICE EXCELLENCE APPROACH FOR MRS. N WITH HYPERTENSION AT THE ELDERLY SOCIAL SERVICE UNIT (UPTD) BINJAI, NORTH SUMATRA, 2025

Thu, 14 Aug 2025 00:00:00 +0700

The elderly stage of life is characterized by a natural decline in physiological function and an increased susceptibility to degenerative diseases such as hypertension. This condition is often referred to as a “silent killer” because it may not present obvious symptoms, yet it can lead to life-threatening complications if left untreated. The purpose of this study was to implement a geriatric nursing care management model using a service excellence approach for Mrs. N, an elderly patient diagnosed with hypertension at the Binjai Elderly Social Service Unit (UPTD) in North Sumatra. A descriptive case study method was applied, integrating a comprehensive nursing process consisting of assessment, nursing diagnosis, care planning, implementation, evaluation, and documentation. Data were collected through interviews, physical assessments, and direct observation. The nursing diagnoses identified during the assessment process included acute pain, sleep pattern disturbance, and knowledge deficit. To address these issues, nursing interventions focused on providing health education, teaching relaxation techniques, and offering emotional and spiritual support tailored to the patient’s needs. These interventions aimed not only to alleviate physical discomfort but also to empower the patient with knowledge and promote holistic well-being through compassionate and patient-centered care. The evaluation revealed significant improvements, including a reduction in pain intensity, better sleep quality, and enhanced understanding of the patient’s health condition. These outcomes indicate that the application of service excellence in geriatric nursing care can positively influence the quality of life of elderly individuals with hypertension. The findings from this study may serve as a valuable reference for future nursing practices, encouraging a more humane, empathetic, and professional approach in delivering healthcare services to older adults.

CONTINUITY OF CARE WITH THE BREAST MILK DAM ON NY. W INDEPENDENT PRACTICE MIDWIFE PERA TUNTUNGAN SUB-DISTRICT MEDAN CITY NORTH SUMATRA PROVINCE YEAR 2025

Thu, 14 Aug 2025 00:00:00 +0700

Continuous health development is essential to improving public health and achieving the Sustainable Development Goals (SDGs) by 2030. The national target aims to reduce the Maternal Mortality Rate (MMR) to 70 per 100,000 live births and the Infant Mortality Rate (IMR) to 12 per 1,000 live births. This study employed a descriptive observational method with a comprehensive midwifery care approach, specifically Continuity of Care (CoC), for Mrs. W. The management followed Varney’s seven-step process and utilized SOAP documentation to systematically track pregnancy, labor, postpartum, newborn, and family planning stages. Midwifery management was successfully implemented across the continuum of care. The results showed that physiological processes were maintained, and theoretical gaps were identified and addressed through clinical practice. The continuity of care provided to Mrs. W was conducted in accordance with midwifery service standards. During pregnancy, the patient remained compliant and complication-free. Labor proceeded normally, and postpartum issues, such as breast milk engorgement, were effectively resolved through breast care and education. Newborn care followed physiological norms, and the patient opted for the Lactational Amenorrhea Method (MAL) for family planning after receiving adequate counseling. Overall, the midwifery care met professional standards, showing no significant gaps between theory and practice, thereby supporting the reduction of maternal and infant risks.

MOTHER'S PERCEPTIONS BASED ON THE HEALTH BELIEF MODEL ABOUT EXCLUSIVE BREASTFEEDING IN PREVENTING STUNTING AT KAMPUNG BARU PUBLIC HEALTH CENTER, MEDAN MAIMUN DISTRICT, MEDAN CITY, NORTH SUMATRA PROVINCE, 2025

Thu, 14 Aug 2025 00:00:00 +0700

Sustainable Development Goal (SDG) number two aims to create a healthy and productive society free from hunger. According to SDG data, the stunting rate among children under five decreased from 24.4% in 2021 to 21.6% in 2022. However, disparities remain across provinces, and national targets have not yet been achieved. Stunting is characterized by a Z-score less than -2 SD (moderate) and less than -3 SD (severe). One of the main obstacles to achieving this goal is the prevalence of malnutrition among children under five, which is a major factor contributing to stunting (Bappenas, 2023). This study aims to explore mothers' perceptions using the Health Belief Model (HBM) regarding exclusive breastfeeding in preventing stunting at the Kampung Baru Health Center in 2025. The research method is analytical, using a cross-sectional design with a Chi-Square test to analyze the influence between variables. The population consists of all mothers with toddlers, with a total of 149 visits recorded in the past year. A sample of 60 mothers was selected. Primary data were collected using questionnaires, and secondary data were obtained through interviews. The results showed that most respondents were aged 31–40 years (66.7%), had a high school education (66.7%), and were housewives (91.7%). There was a statistically significant relationship between perceived susceptibility (p=0.009), perceived severity (p=0.024), and perceived benefits (p=0.013) with the practice of exclusive breastfeeding in preventing stunting. In contrast, perceived barriers did not show a significant influence (p=0.709). Conclusion: There is a significant relationship between mothers' perceptions of susceptibility, severity, and benefits and the practice of exclusive breastfeeding in preventing stunting, while perceived barriers had no significant impact. Educational interventions should focus on enhancing mothers’ positive perceptions of the importance of exclusive breastfeeding.

FAMILY NURSING CARE MANAGEMENT WITH EXCELLENT SERVICE FOR Mrs. S WITH HYPERTENSION IN BANGUN REJO VILLAGE, TANJUNG MORAWA DISTRICT, DELI SERDANG REGENCY, NORTH SUMATRA PROVINCE IN 2025

Thu, 14 Aug 2025 00:00:00 +0700

Hypertension is a chronic, non- ommunicable disease that significantly affects global public health, contributing to hing rates of morbidity and mortality. This scientific writing aims to implement family nursing care management using a service excllent approach for Mrs. S, a 46 year-old female resident of Bangun Rejo Village, Tanjung Morawa Subdistrict, Deli serdang District, North Sumatra Province, diagnosed with savere hypertension. The case study method was applied with a descriptive design, planning, implementation, and evaluation. Initial assessment revealed that Mrs. S had a blood pressure of 188/136 mmHg, along with clical symptoms such as persistent headache, dizziness, numbness in both hands and feet, and occasional nosebleeds. For nursing diagnoses were identified : ineffective cerebral tissue perfusion, acute pain, ineffective family health management, and decreased cardiac output. Interventions focused on health education, dietary regulation, routine vital signs monitoring, stress management through relaxation techniques, and empowering the family to provide daily support and care. The outcomes showed significant improvement in the patient’ s clinical condition and family engagement. The family became more responsive and capable in managing the disease, inculding understanding medication compliance, identifying triggers, and adoping healthier lifestyles. Furthermore, the service excllent approach-centered on respect, empathy, and patient centered care helped build trust between the patient , family and healthcare provider, making the care process more effective.

CONTINUITY OF CARE IN NIAS C WITH A SECOND-DEGREE PERINEAL RUPTUR AT THE VINA PRATAMA CLINIC, MEDAN CITY

Thu, 14 Aug 2025 00:00:00 +0700

The improvement of maternal and child health remains a primary indicator of a nation's health development success, particularly in alignment with the Sustainable Development Goals (SDGs) to reduce the Maternal Mortality Rate (MMR). Perineal rupture, a common tear during childbirth, can lead to severe complications such as hemorrhage, infection, and hematoma if left untreated. This study aims to provide comprehensive midwifery care through a Continuity of Care (COC) approach for Mrs. C at the Vina Pratama Clinic, Medan City, in 2025. The research method utilized primary data collection through direct interviews and clinical assessments, tracking the patient from the third trimester of pregnancy through delivery, the postpartum period, and family planning. During the second stage of labor, the patient delivered a male baby spontaneously weighing 3800 grams with an Apgar score of 10. This resulted in a second-degree perineal rupture affecting the vaginal mucosa, posterior commissure, perineal skin, and muscles. Clinical management included hemostatic compression to expedite wound healing and the provision of education on antiseptic protocols and the Lactational Amenorrhea Method (LAM) for family planning. The study concludes that the COC model ensures a stable relationship between the midwife and patient, which is vital for monitoring recovery, preventing infection, and reducing the risk of maternal morbidity.

EDUCATION ON THE HANDLING AND PREVENTION OF MILD ANEMIA IN PREGNANT WOMEN IN THE WORKING AREA OF THE TUNGUNGAN PUBLIC HEALTH CENTER IN MEDAN CITY IN 2024

Thu, 14 Aug 2025 00:00:00 +0700

ABSTRACT

Anemia adalah kondisi ketika kadar hemoglobin dalam darah berada di bawah batas normal, dengan nilai acuan yang bervariasi tergantung pada usia dan jenis kelamin individu. Penelitian ini berfokus pada hubungan antara tingkat pendidikan dan kasus anemia pada ibu hamil. Penyebab utama anemia karena ibu hamil kekurangan asupan zat besi ,vit D ,vit b12,kekurangan sel darah . Studi kasus ini menggambarkan penanganan anemia pada seorang ibu hamil usia 25 tahun dengan gestasi 17 minggu 4 hari . Asuhan yang diberikan meliputi Pemberian tablet FE dan memberikan kie terkait makanan bergizi serta menganjurkan untuk sering melakukan kunjungan ANC Tujuan dari pengabdian ini adalah untuk meningkatkan pemahaman ibu hamil mengenai pencegahan dan penanganan anemia di wilayah kerja puskesmas tuntungan . Metode yang digunakan dalam pengabdian ini adalah edukasi dan pemberian tablet Fe. Hasil dari kegiatan ini menunjukkan peningkatan pengetahuanibu hamil mengenai anema dan cara pencegahan anemia . Kesimpulannya, edukasi dan intervensi pemberian tablet Fe dalam menangani kasus di wilayah ini.

FAMILY NURSING CARE MANAGEMENT WITH SERVICE EXCELLENCE FOR MRS. S WITH PULMONARY TUBERCULOSIS IN BANGUN REJO VILLAGE TANJUNG MORAWA SUBDISTRICT DELI SERDANG REGENCY NORTH SUMATRA PROVINCE YEAR 2025

Thu, 14 Aug 2025 00:00:00 +0700

ABSTRACT

Pulmonary Tuberculosis (TB) remains one of the most significant infectious diseases affecting public health, particularly in Indonesia, which ranks second globally in TB cases after India. TB is an airborne infectious disease that primarily affects the lungs. This case study aims to describe the implementation of family nursing care management using a service excellent approach for a patient, Mrs. S, diagnosed with Pulmonary Tuberculosis and residing in Bangun Rejo Village, Tanjung Morawa District, Deli Serdang Regency. The research employed a descriptive case study method with a systematic nursing process including assessment, nursing diagnosis, care planning, implementation, and evaluation. The initial assessment revealed several nursing problems: ineffective airway clearance, nutritional deficit, activity intolerance, and lack of family knowledge regarding TB and adherence to treatment. Interventions were carried out through educational, collaborative, and supportive approaches involving the family as active care partners. Education was focused on treatment adherence, proper nutrition, and infection prevention. The results showed improved family understanding, increased treatment compliance, and better overall health condition of the patient. The evaluation phase indicated that active family engagement significantly contributed to treatment success and enhanced the patient’s quality of life. In conclusion, the application of family nursing care based on service excellent principles plays a crucial role in reducing the incidence of Pulmonary Tuberculosis and improving therapeutic outcomes at the community level.

MANAGEMENT OF EMERGENCY NURSING CARE WITH SERVICE EXCELLENCE IN MR. D WITH SECOND-DEGREE BURNS AT THE EMERGENCY DEPARTMENT OF H. ADAM MALIK CENTRAL GENERAL HOSPITAL MEDAN NORTH SUMATRA PROVINCE IN 2025

Thu, 14 Aug 2025 00:00:00 +0700

ABSTRACT

Burns are a type of severe burn that not only affects the skin, but can also damage deeper tissue and cause systemic disorders in a person's body. The goal is to maintain the safety of the victim, protect those who help, prevent infection, relieve pain and anxiety in a person, and maintain the victim's condition until medical personnel arrive to provide further treatment. The method used in my research is a descriptive method, which systematically describes the nursing process carried out starting from assessing the patient's condition, determining the diagnosis, formulating interventions, implementing actions, and evaluating the results of the implementation, as evidenced by documentation and using the Orem theory approach related to the problem of burns. According to WHO data in 2023, burns are a health problem that has recorded more than 265,000 people worldwide who have died. According to the Ministry of Health of the Republic of Indonesia (2020), the prevalence of burns in Indonesia in 2020 was recorded at 0.7%, a decrease of 1.5% compared to 2008 which reached 2.2%. According to Riskesdas, the number of burn patients in North Sumatra reached 1.0% of the total 5,401 people. Meanwhile, in Medan City, there were 89 people suffering from burns. Based on information obtained from the Medical Record book of the H. Adam Malik Medan General Hospital (RSUP), in 2021 there were 21 more patients, namely in 2022, becoming 43 people. continuing in 2023, increasing to 60 people. However, in 2024, there was a slight decrease, namely 52 patients were recorded, and burn data at the H. Adam Malik Medan Hospital on April 26-29, 2025 in the Surgical ICU Room there were 2 people. The selection of burn cases is the focus of discussion based on the contribution of nurses in holistic burn treatment, both in terms of physical, psychological, and educational, in order to accelerate the healing process related to SGDs No. 3 and 17. So, it makes me interested in taking the title of the final report with the title "Emergency Nursing Care Management with Grade II Burns on Mr. D. in the IGD Room of H. Adam Malik General Hospital, Medan, North Sumatra Province in 2025".

FACTORS INFLUENCING THE FAILURE OF EXCLUSIVE BREASTFEEDING IN SRI DAMAI VILLAGE MUSI BANYUASIN REGENCY SOUTH SUMATRA PROVINCE IN 2024

Thu, 14 Aug 2025 00:00:00 +0700

Background: Exclusive breastfeeding plays a crucial role in reducing infant mortality and promoting optimal child growth and development. Despite its importance, the rate of exclusive breastfeeding in Indonesia remains low, including in Sri Damai Village. Several factors such as maternal age, education, occupation, parity, knowledge, and family support are thought to influence the success of exclusive breastfeeding. Research objective: This study aims to comprehensively identify the various factors that contribute to the failure of exclusive breastfeeding in Sri Damai Village. These factors may include sociodemographic conditions, cultural beliefs, maternal knowledge and attitudes, family support, and the role of healthcare services. Methode: his research is a quantitative study with a cross-sectional design. The sample consisted of 34 mothers with infants aged 0–6 months in Sri Damai Village. Data were collected using a structured questionnaire and analyzed using the Chi-Square test. Research results: The study found that the failure of exclusive breastfeeding in Sri Damai Village was influenced by several key factors. Mothers aged 20–35 years made up 58.8% of cases, showing that being in the ideal reproductive age does not ensure successful breastfeeding. Statistical analysis confirmed significant relationships between all these variables and exclusive breastfeeding failure (p < 0.05). Conclusion and suggestion: The failure of exclusive breastfeeding in Sri Damai Village is influenced by several factors, with lack of family support and poor application of maternal knowledge being the most significant.

Keywords: Exclusive Breastfeeding, Failure, Maternal Knowledge, Family Support, Contributing Factors

CONTINUITY OF MIDWIFERY CARE FOR MRS. F EXPERIENCING UMBILICAL CORD ENTANGLEMENT AT MANDREHE HEALTH CENTER, MANDREHE DISTRICT, WEST NIAS REGENCY, IN 2025

Thu, 14 Aug 2025 00:00:00 +0700

Background: Comprehensive midwifery care is a strategic effort to reduce Maternal Mortality Rate (MMR) and Infant Mortality Rate (IMR) in line with the Sustainable Development Goals (SDGs). Umbilical cord entanglement is a labor complication that can cause asphyxia or even fetal death if not managed correctly. Objective: To provide comprehensive continuity of care to Mrs. F from the third trimester of pregnancy, childbirth with umbilical cord entanglement, postpartum, newborn care, to family planning services. Methods: A descriptive case study using Varney’s 7-step midwifery management and SOAP documentation. The subject was Mrs. F (26 years old, G3P2A0) at Mandrehe Health Center, West Nias Regency. Results: During pregnancy, physiological complaints of frequent urination were managed through fluid intake education. During the second stage of labor, a single loop of umbilical cord entanglement was found around the baby's neck and successfully managed by loosening the cord. The baby was born spontaneously, healthy, male, weighing 3,500 grams, length 51 cm, with an APGAR score of 10. The postpartum period was normal across four visits, the newborn received complete basic immunizations, and the mother chose the Lactational Amenorrhea Method (LAM) for contraception. Conclusion: The implementation of comprehensive care proved effective in early detection and management of umbilical cord entanglement complications, ensuring the safety of both mother and baby.

THE RELATIONSHIP BETWEEN POST-PART MOTHER CHARACTERISTICS AND THE INCIDENCE OF BABY BLUES IN THE INDEPENDENT PRACTICE OF MIDWIFE KRISTIANI NAPITUPULU TANJUNG MORAWA DISTRICT

Thu, 14 Aug 2025 00:00:00 +0700

The 5th Mitra Husada Health International Conference (MiHHICo) 2025
Volume 5 (2025) ISSN: 2988-3768
139
HUBUNGAN KARAKTERISTIK IBU PASCA PARTAI
DENGAN KEJADIAN BABY BLUES PADA
PRAKTIK MANDIRI BIDAN KRISTIANI NAPITUPULU
KABUPATEN TANJUNG MORAWA
Oca Floren Simanullang 1,Siti Nurmawan Sinaga 2, Febriana Sari 3, Dora Cristina Br. Karo
4,Sonia Naesza Adelia Suherman, 5, Sitti Nuraisyah6 Kristiani Napitupulu7
STIKes Mitra Husada Medan
Email: ocafloren20@gmail.com
ABSTRAK
Baby blues syndrome merupakan gangguan emosi ringan yang umum terjadi pada masa nifas dan
dapat berdampak buruk pada kesehatan ibu dan tumbuh kembang bayi. Tujuan penelitian ini adalah
untuk menganalisis hubungan antara karakteristik ibu pascapersalinan termasuk usia, paritas, jenis
persalinan, dan status kehamilan dengan kejadian baby blues di Praktik
Bidan Kristen Napitupulu, Kecamatan Tanjung Morawa, Kabupaten Deli Serdang pada tahun 2024. Penelitian ini
menggunakan desain observasional analitik korelasional dengan pendekatan cross-sectional. Sampel
terdiri dari 38 responden yang diambil menggunakan teknik purposive sampling dan dianalisis menggunakan
uji chi-square. Hasil penelitian menunjukkan bahwa mayoritas ibu pascapersalinan berusia 26-30 tahun (52,6%),
primipara (68,4%), persalinan normal (81,6%), dan kehamilan yang direncanakan (71,1%). Baby blues dialami
oleh 52,6% responden. Hasil uji statistik menunjukkan hubungan yang signifikan antara
paralisis (p = 0,003), jenis persalinan (p = 0,024), dan status kehamilan (p = 0,021) dengan terjadinya
baby blues. Kesimpulan dari penelitian ini adalah bahwa karakteristik ibu pascapersalinan, khususnya
paralisis, jenis persalinan, dan status kehamilan, berhubungan secara signifikan dengan terjadinya
baby blues. Diharapkan hasil ini dapat memberikan dasar bagi petugas kesehatan dalam memberikan edukasi
dan dukungan psikologis kepada ibu pascapersalinan untuk mencegah sindrom baby blues.

MENTAL HEALTH NURSING CARE MANAGEMENT BASED ON SERVICE EXCELLENCE FOR MR. D WITH VIOLENT BEHAVIOR AT PROF. DR. MUHAMMAD ILDREM PSYCHIATRIC HOSPITAL, NORTH SUMATRA PROVINCE, MEDAN CITY, 2025

Thu, 14 Aug 2025 00:00:00 +0700

Mental disorders, particularly violent behavior, remain a serious challenge in mental health services in Indonesia. Violent behavior exhibited by individuals with mental disorders not only endangers themselves but also threatens the safety of others and the environment. This study aims to explore mental health nursing care management based on service excellence in patients with violent behavior, focusing on a case study of Mr. D at Prof. Dr. Muhammad Ildrem Psychiatric Hospital in Medan. The research method used is a descriptive qualitative case study approach through interviews, observations, and documentation. The results showed that Mr. D was diagnosed with paranoid schizophrenia and had a history of violent behavior marked by emotional instability, aggression, and low self-esteem. Nursing interventions focused on building trust, relaxation techniques training, assertive communication, spiritual approaches, and medication adherence. Evaluation results indicated a decrease in the frequency of violent behavior and improvement in the patient’s self-control. This study emphasizes the importance of a holistic approach and quality nursing services in managing mental disorder patients with violent behavior

CONTINUITY OF MIDWIFERY CARE FOR MRS. B WITH SECOND-DEGREE PERINEAL RUPTURE AT PMB PERA, MEDAN TUNTUNGAN DISTRICT, NORTH SUMATRA PROVINCE, IN 2025

Thu, 14 Aug 2025 00:00:00 +0700

Background: Perineal rupture is a tear in the perineum occurring during delivery, either spontaneously or through instrumental assistance. These tears often occur along the midline and can become extensive if the fetal head is delivered too rapidly. Key contributing factors include parity, birth weight, and the duration of the second stage of labor. Objective:This study aims to provide and analyze comprehensive midwifery care for Mrs. B, specifically focusing on the management and prevention of perineal rupture. Methods: A descriptive case study approach was employed using Continuity of Care (CoC). The care was implemented through the Helen Varney midwifery management method and documented using SOAP notes, spanning from pregnancy and childbirth to newborn care, postpartum, and family planning. Results: The study identified that proper management of the second stage of labor and controlled delivery techniques are crucial in minimizing spontaneous perineal tears. Mrs. B received integrated education on perineal health and postpartum recovery. Conclusion: Continuous midwifery care using the Varney method effectively monitors risk factors and ensures the delivery of high-quality, comprehensive care to reduce maternal morbidity related to perineal trauma.

EXCELLENT GEREONETIC NURSING CARE MANAGEMENT FOR MRS. Y WITH HYPERTENSION AT THE SOCIAL SERVICES UPTD FOR THE ELDERLY IN BINJAI NORTH SUMATERA PROVINCE SOCIAL SERVICES DEPARTMENT 2025

Thu, 14 Aug 2025 00:00:00 +0700

ABSTRACT

Hypertension is a medical condition characterized by elevated blood pressure, with systolic pressure ≥140 mmHg and diastolic pressure ≥90 mmHg based on repeated measurements. This study is a descriptive case study approach conducted at the Binjai Elderly Social Services Unit (UPTD) in 2025. The nursing process was carried out systematically, including assessment, diagnosis, planning, implementation, and evaluation. The study subject was one elderly person with hypertension. Nursing interventions in practice did not fully follow the theory, particularly in terms of detailing the objectives and methods of intervention. However, both have the same goal: maintaining blood pressure within normal limits. Furthermore, care focused on pain reduction using the PQRST technique. The program was implemented over three days, with key interventions including vital sign monitoring, pain assessment, hypertension exercises, and deep breathing relaxation. Results showed a decrease in pain from 7 to 5, improved sleep quality, decreased anxiety, and a decrease in blood pressure to 140/80 mmHg. The client was also able to perform some scheduled activities. Further nursing interventions were carried out by the Binjai Social Service for the Elderly.

CONTINUITY OF MIDWIFERY CARE (CONTINUITY OF CARE) FOR MRS. W AGE 35 WITH RUPTURE PERINEUM DEGREE I AT THE INDEPENDENT PRACTICE OF MIDWIFE RONNI SIREGAR SUNGGAL DISTRICT DELI SERDANG REGENCY NORTH SUMATRA YEAR 2025

Wed, 07 Jan 2026 00:00:00 +0700

ABSTRACT

Midwifery care is a series of activities or interventions provided by midwives to clients who have specific needs or health problems, particularly in maternal and child health (MCH) services and family planning. Midwifery care refers to the implementation of the roles, functions, and responsibilities of midwives in delivering services to clients with obstetric needs or conditions, including pregnancy, childbirth, the postpartum period, newborn care, family planning, as well as women's reproductive health and public health services. The purpose of this study is to describe the implementation of continuity of care midwifery services for a client throughout pregnancy, childbirth, postpartum period, newborn care, and family planning in Mrs. W at PMB Ronni Siregar, through the application of midwifery care management in accordance with midwives' competencies. The population in this midwifery care activity consists of a pregnant woman, Mrs. W, aged 35 years, pregnant 3 para 2 abortus 0 (G3P2A0), starting from 37 weeks and 1 day of gestation.

EDUCATION ON THE MANAGEMENT AND PREVENTION OF MALNUTRITION IN TODDLERS IN THE WORKING AREA OF RANTANG HEALTH CENTER, MEDAN CITY

Wed, 07 Jan 2026 00:00:00 +0700

ABSTRACT

Malnutrition is a condition in which the body does not receive sufficient intake of essential nutrients such as proteins, vitamins, calories, and minerals. This condition can lead to severe health issues, including wasting and stunting in children, making malnutrition a critical concern. Around 150.2 million children under five in the world are stunted and 42.8 million are wasting. In Indonesia, the results of the 2023 Indonesian Health Survey (SKI) and SSGI 2024 show that the national stunting prevalence is at 19.8%. The research design used is using a Quasi-Experimental design with a Pretest-Posttest Control Group design. The study population was all mothers who had toddlers aged 12–59 months in the working area of the Rantang Health Center. The sampling technique uses Probability Sampling with the Simple Random Sampling method. Based on the results of research and discussions that have been carried out in the Rantang Health Center Working Area, Medan City in 2024, the following conclusions can be drawn: Improvement of Knowledge and Attitudes: There is a significant influence of providing education on management and malnutrition prevention education on the level of knowledge and attitudes of mothers under five. The intervention group showed an increase in knowledge scores of 26.33 points and attitudes of 16.80 points (p < 0.001). Structured and interactive education has proven to be much more effective than conventional counseling methods (controls) that only provide one-way information. This proves that a comprehensive educational approach is able to solve the barriers to nutrition literacy in urban communities. Impact on Nutritional Status: Although changes in anthropometric nutritional status (BB/U) require a longer monitoring time, this study noted an improvement in daily diet (protein intake) in toddlers in the intervention group, which is an early indicator of sustained malnutrition prevention.

CONTINUITY OF CARE IN BABY MR. I WITH MILD ASPHYXIA AT PMB BD WANTI S.KEB FISHING STREET MARKET 4 MABAR DOWNSTREAM OF MEDAN DELI DISTRICT MEDAN CITY 2025

Wed, 07 Jan 2026 00:00:00 +0700

ABSTRACT

According to Sustainable Development Goals (SDGs) data, the global Infant Mortality Rate (IMR) has experienced a significant decline in the last decade, with a decline of 51% between 1990 and 2021. (Hadi Ashar, 2023) Despite global improvements, IMR remains a major challenge, with several ASEAN countries in the region having high rates of asphyxia, namely Indonesia with 23.5 live births per 1000, the Philippines with 24.6 live births per 1000, Cambodia 28.4 per 1000 live births, Laos 31.4 per 1000 with live births, Myanmar 35.1 per 1000 live births. (Tia Nurfitri, 2022) Purpose: Providing comprehensive midwifery care to Mrs. I at PMB Bd Wanti S.Keb Jalan Pancing Pasar 4 Mabar Hilir, Medan Deli District, Medan City. (Interested in Rahayu Syafitri, 2023) This includes assessment and actions during pregnancy, childbirth, postpartum, newborns, and family planning. Method: The comprehensive care method for Mrs. I in the context of qualitative (descriptive) research is an approach used to thoroughly understand and analyze the conditions, processes, or phenomena within an individual. (Shefaly Shorey, 2024) Comprehensive care focuses on a very broad and comprehensive understanding, which does not only look at one aspect but also various related dimensions. Result: the baby was born alive with asphyxia at 14.30 WIB, famale gander, body lenght 50 cm, lilac 11cm, head circumference 32 cm, chest circumference 32cm apgar score 7

MIDWIFERY CARE MANAGEMENT FOR MRS. D IN PHYSIOLOGICAL POSTPARTUM PERIOD WITH LOW BREAST MILK SUPPLY AT PMB RIYANTI BANGETAYU KULON GENUK, SEMARANG CITY, CENTRAL JAVA PROVINCE IN 2024

Thu, 14 Aug 2025 00:00:00 +0700

The postpartum phase begins immediately after the delivery of the infant and placenta, spanning approximately six weeks. During this window, the maternal reproductive system undergoes "involution," a process where organs gradually return to their pre-gestational state. This period is a high-risk transition for both the mother and the newborn; statistically, 60% of maternal complications leading to death occur post-delivery, with half of those fatalities happening within the initial 24 hours. Consequently, rigorous monitoring is vital to mitigate mortality rates. In the case of Mrs. D, a physiological postpartum assessment revealed limited lactation but no pathological indicators such as mastitis, abscesses, or malignancies. The diminished milk supply was attributed to insufficient suckling stimulation rather than underlying illness. Ultimately, the 2024 case study at PMB Bd. Riyanti confirms that Mrs. D’s recovery followed a normal trajectory, with vital signs remaining stable and the clinical management aligning perfectly with established midwifery theories.

THE EFFECT OF DIGITAL LACTATION EDUCATION INTERVENTION ON MILD DEPRESSION LEVELS IN POSTPARTUM MOTHERS IN HEALTH CRISIS SITUATIONS

Thu, 14 Aug 2025 00:00:00 +0700

Postpartum period is a critical phase marked by significant physiological, emotional, and psychological changes in women. During health crisis situations, such as the COVID-19 pandemic, the risk of postpartum mental health problems, including mild postpartum depression, increases due to limited access to health services and social support. Digital lactation education has emerged as a strategic intervention to support breastfeeding practices while simultaneously improving maternal psychological well-being. Objective: This study aimed to examine the effect of digital lactation education interventions on reducing mild postpartum depression symptoms during health crisis situations. Methods: A narrative literature review was conducted by analyzing five relevant scientific articles published between 2019 and 2024. Articles were retrieved from Google Scholar, PubMed, ScienceDirect, and DOAJ using keywords related to digital lactation education, postpartum depression, and mobile health. Results: The reviewed studies consistently demonstrated that digital-based lactation education—delivered through educational videos, mobile health (mHealth) applications, online peer support, and virtual counseling—effectively reduced anxiety, enhanced maternal self-confidence, and alleviated mild postpartum depression symptoms. Conclusion: Digital lactation education interventions are effective non-pharmacological strategies for supporting breastfeeding practices and improving maternal mental health, particularly during health crises when face-to-face services are limited.

UTILIZATION OF BOILED MORINGA LEAF WATER TO INCREASE BREAST MILK PRODUCTION POSTPARTUM MOTHERS AT TANJUNG LEIDONG PUBLIC HEALTH CENTER

Thu, 14 Aug 2025 00:00:00 +0700

Low breast milk production is a challenge for postpartum mothers in meeting their babies' nutritional needs, especially in the first six months of life. Various efforts have been made to increase breast milk production, one of which is through the consumption of boiled water from Moringa oleifera leaves, known as a natural galactagogue. Objective: To determine the effectiveness of using boiled water from Moringa leaves on increasing breast milk production in postpartum mothers. Method: This study used a pre-experimental design with a one-group pretest-posttest approach. A sample of 20 postpartum mothers who met the inclusion criteria were given an intervention of boiled water from Moringa leaves twice daily for seven days. Breast milk production was measured before and after the intervention using a breast milk volume observation sheet. Results: A paired t-test showed significant results with a p-value of 0.000. Conclusion: Boiled water from Moringa leaves is effective in increasing breast milk production in postpartum mothers.

CONTINUITY OF CARE FOR PREGNANT WOMEN WITH MILD ANEMIA AT THE SERASI PRATAMA CLINIC, MEDAN HELVETIA DISTRICT, MEDAN CITY, NORTH SUMATERA PROVINCE 2025

Thu, 08 Jan 2026 00:00:00 +0700

Anemia in pregnancy is a condition characterized by decreased hemoglobin (Hb) levels in the blood of pregnant women. Mild anemia is usually characterized by Hb levels between 9–10.9 g/dL. This condition often occurs due to increased iron requirements during pregnancy that are not balanced by adequate intake. Several factors contributing to low awareness of anemia in pregnant women include limited access to accurate information, varying levels of education, and dietary habits that do not meet nutritional needs during pregnancy. Furthermore, nausea and vomiting, often experienced in the first trimester of pregnancy, are also major reasons mothers are reluctant to consume nutritious foods and iron supplements. Therefore, more interactive and easy-to-understand educational methods are needed so that pregnant women can adopt a healthy lifestyle during pregnancy. Pregnant women are required to regulate their diet to meet nutritional needs. A balanced diet consists of appropriate amounts and proportions of carbohydrates, protein, minerals, vegetables, and vitamins to meet the needs of the body. (Delfina et al., 2024)

MANAGEMENT OF GERIATRIC NURSING CARE WITH EXCELLENT SERVICE FOR Mrs. R WITH TYPE II DIABETES MELITUS AT THE ELDERLLY SERVICE UNIT BINJAI, NORTH SUMATERA PROVINCE, IN 2025

Thu, 08 Jan 2026 00:00:00 +0700

The increasing number of elderly people who experience chronic diseases, especially type II diabetes mellitus, is a challenge in gerontic nursing services. This scientific paper aims to apply gerontic nursing care management based on service excellence to Mrs. R, a 71-year-old elderly who suffers from type II diabetes mellitus, at UPTD Social Services for the Elderly Binjai, North Sumatera. This writing uses a descriptive case study approach with data collection methods through observation, interviews, and physical examinations. The main focus of nursing interventions includes managing blood glucose levels, handling skin integrity disorders due to diabetic ulcers, and controlling acute pain. The results of nursing care showed an improvement in the patient's clinical condition, characterized by a decrease in blood glucose levels from 284 mg/dl to 101 mg/dl, reduced pain, and increased patient awareness of a healthy lifestyle. The service excellent approach applied positively contributed to the patient's quality of life and supported the achievement of the Sustainable Development Goals (SDGs) target point 3.4, specifically in reducing premature mortality due to non-communicable diseases. This work confirms the importance of comprehensive, humanist, and sustainable nursing care in elderly health services in the era of globalization.

SERVICE EXCELLENT SURGICAL MEDICAL NURSING CARE MANAGEMENT ON TN. D WITH TYPE II DIABETES MELLITUS WITH INDICATIONS OF DIABETIC ULCERS IN ROOM RA 4 RSUP H. ADAM MALIK CITY MEDAN NORTH SUMATERA YEAR 2025

Thu, 08 Jan 2026 00:00:00 +0700

Diabetes Mellitus Type II remains a prevalent chronic disease in Indonesia, often leading to serious complications such as diabetic foot ulcers when left unmanaged. This scientific paper presents a comprehensive nursing care management approach with a focus on service excellence for a patient diagnosed with Type II Diabetes Mellitus and diabetic ulcers. The case study involved a 51-year-old male patient (Mr. D) admitted to the RA 4 Ward of H. Adam Malik General Hospital in Medan. The nursing process implemented included five stages: assessment, diagnosis, planning, intervention, and evaluation, guided by the standards outlined in the Indonesian Nursing Diagnosis and Intervention System (SDKI & SIKI). Key nursing diagnoses identified were unstable blood glucose levels, impaired tissue integrity, and limited physical mobility. Over the course of three consecutive days, targeted nursing interventions were administered, including wound care, blood glucose monitoring, patient education, and collaboration with the healthcare team. The outcomes indicated notable clinical improvements in wound healing, glycemic control, and patient awareness. This case highlights the importance of an integrated and empathetic nursing approach that emphasizes professional, accountable, collaborative, and patient-centered care—consistent with the PACER values adopted by STIKes Mitra Husada Medan. Furthermore, the findings support the significance of early health education, family involvement, and lifestyle modification in diabetes management. The application of excellent service within the nursing process not only contributes to better patient outcomes but also aligns with Indonesia’s broader health goals, particularly in reducing complications and promoting sustainable healthcare delivery. Through this study, nurses are encouraged to adopt evidence-based strategies that combine clinical precision with compassionate care, ultimately enhancing the quality of life for patients with chronic illnesses such as diabetes.

EXCELLENT MENTAL NURSING CARE MANAGEMENT FOR Mr. A WITH SELF-CARE DEFICIT IN THE SORIK MERAPI 3 WORLD AT THE PROF. Dr. MUHAMMAD ILDREM MENTAL HOSPITAL, MEDAN, NORTH SUMATRA PROVINCE IN 2025

Thu, 08 Jan 2026 00:00:00 +0700

Mental disorders are mental health conditions that can interfere with an individuals abilitiy to carry out daily activities, including self-care. Self-care deficit reflects a decrease or loss of a persons ability to meet basic needs such as personal hygiene, dressing, eating, and maintaining appearance. This condition is often found in individuals with mental disorders, especially schizophrenia, due to cognitive disorders, low motivation, and lack of awareness of their condition. A structured nursing approach and environmental support play a major role in improving self-care skills in patients. The role of psychiatric nurses is very important in indentifying problems, providing interventions, and motivating patients to achieve independence gradually. With the provision of appropriate nursing care, it is hoped that patients will be able to improve their quality of life and reduce dependence on others.

FAMILY NURSING CARE MANAGEMENT WITH EXCELLENT SERVICE FOR Mrs. R WITH RHEUMATOID ARTHRITIS

Thu, 14 Aug 2025 00:00:00 +0700

Artritis Reumatoid (RA) adalah penyakit inflamasi kronis yang menyebabkan nyeri, kaku, dan bengkak pada persendian dan dapat memengaruhi seluruh tubuh. Kondisi autoimun dan progresif ini, jika tidak dikelola dengan baik, dapat menurunkan kualitas hidup pasien. Manajemen medis yang tepat dan keterlibatan keluarga sangat penting untuk meningkatkan kemandirian pasien. Tujuan: (Lucia Firsty dkk, 2024). Penelitian ini bertujuan untuk mendeskripsikan perawatan keperawatan pada pasien dengan Artritis Reumatoid dan menjelaskan upaya untuk mengurangi nyeri dan meningkatkan kemampuan pasien dalam melakukan aktivitas sehari-hari. Metode: Penelitian ini menggunakan pendekatan studi kasus deskriptif, yang terdiri dari asesmen, penentuan diagnosis keperawatan, perencanaan, implementasi, dan evaluasi. (Mariyam Yusefa, 2023). Data diperoleh melalui wawancara, observasi, dan studi dokumentasi. Hasil: Hasil penelitian menunjukkan bahwa pasien mengalami nyeri kronis pada persendian lutut dan tangan, disertai dengan keterbatasan mobilitas akibat kekakuan sendi. Intervensi keperawatan yang diberikan meliputi pendidikan kesehatan, latihan rentang gerak (ROM), dan pengaturan aktivitas dan istirahat. (Niswa Salamung, 2021). Setelah tindakan keperawatan diterapkan, terjadi penurunan intensitas nyeri dan peningkatan kemampuan pasien dalam melakukan aktivitas sehari-hari. Kesimpulan: Perawatan keperawatan yang komprehensif dan berkelanjutan untuk pasien dengan Artritis Reumatoid dapat membantu mengurangi nyeri, meningkatkan mobilitas, dan meningkatkan kualitas hidup. Pendekatan edukasi dan dukungan keluarga memainkan peran penting dalam keberhasilan proses perawatan keperawatan. (Xu Zheng dkk. , 2024)

CONTINUITY OF CARE WITH ANEMIA DURING PREGNANCY IN Mrs. C AT THE PRATAMA SERASI CLINIC, HELVETIA DISTRICT

Thu, 14 Aug 2025 00:00:00 +0700

Selama kehamilan, berbagai komplikasi dapat muncul, salah satunya adalah anemia. Anemia pada ibu hamil adalah kondisi ketika kadar hemoglobin dalam darah berada di bawah tingkat normal. Hemoglobin sendiri merupakan protein dalam sel darah merah yang berperan penting dalam mengangkut oksigen ke seluruh tubuh. Pada ibu hamil, anemia biasanya didefinisikan sebagai kadar hemoglobin yang berada di bawah ambang batas tertentu yang telah ditetapkan sebagai standar kesehatan. (Herien, 2024). Masalah dalam studi kasus ini adalah bagaimana perawatan obstetri dilakukan di NY. C secara komprehensif mencakup "perawatan obstetri untuk kehamilan, persalinan, pascapersalinan dan bayi baru lahir serta keluarga berencana dengan pendekatan manajemen Kebidanan Helen Varney dan Dokumentasi SOAP di Klinik Pratama Serasi di Kota Medan. Tujuan penelitian ini diharapkan dapat melakukan studi data yang diperoleh sesuai dengan perawatan obstetri berkelanjutan mulai dari trimester ketiga kehamilan, persalinan, pascapersalinan, menyusui, dan keluarga berencana pada Ibu C berusia 25 tahun G1P0A0 di klinik primer di Distrik Helvetia, Kota Medan. Metode yang digunakan adalah pendekatan kepada pasien melalui wawancara dengan teknik studi kasus, yang bertujuan untuk mendapatkan pemahaman tentang kondisi ibu hamil di Klinik Pratama Serasi pada tahun 2024. Penerapan perawatan obstetri berkelanjutan pada Ibu C, ibu hamil dengan (Hb 8,3 g/dL), telah terbukti efektif dalam meningkatkan kadar Hb menjadi 11,2 dl sebelum persalinan. Keberhasilan ini didukung oleh pemberian tablet penambah darah, konsumsi rutin bit dan buah naga serta pemantauan kamilan secara berkala. Proses persalinan berjalan normal tanpa komplikasi, secara fisiologis, bayi lahir sehat, dan ibu memilih metode kontrasepsi alami untuk gangguan stres pascatrauma (MAL) dan tertarik untuk menggunakan IUD dalam jangka waktu lama. Hal ini menunjukkan bahwa perawatan kebidanan yang dilakukan secara menyeluruh dan berkelanjutan dapat secara optimal meningkatkan status kesehatan ibu dan bayi.

CONTINUITY OF CARE IN NY A WITH A HIGH-RISK PREGNANCY IN SARFINA IN PATIENT PRIMARY CLINIC MEDAN POLONIA DISTRICT

Thu, 14 Aug 2025 00:00:00 +0700

Menurut data Organisasi Kesehatan Dunia (WHO), pada tahun 2024 angka AKI di dunia mencapai 295.000, terutama di kawasan ASEAN dengan angka 953/100.000 KH. Penduduk dengan angka AKI tertinggi adalah Myanmar dengan 282/100.000 KH, Laos dengan 185/100.000 KH, dan angka AKI terendah ditemukan di Singapura. Di Indonesia, angka AKI pada tahun 2022 menunjukkan 4.627 dan penyebab kematian ibu adalah 34,2%, serta Dinas Kesehatan Provinsi Sumatera Utara memiliki angka AKI sebesar 98,6/100.000 KH. Nilai AKI dan AKB yang tinggi menunjukkan adanya masalah kesehatan serius di suatu daerah. Kematian ibu di dunia umumnya disebabkan oleh komplikasi yang terjadi selama kehamilan dan persalinan. Angka kematian ibu mengacu pada angka kematian ibu yang disebabkan oleh berbagai faktor, seperti 24% dari proses kehamilan, 36% dari proses persalinan, dan 40% pasca persalinan setelah melahirkan dalam kondisi tertentu. (Indonesia 2022). Berdasarkan data rekapitulasi register ibu hamil di Desa Sari Rejo, Kecamatan Medan Polonia tahun 2023, terdapat 13 ibu hamil berisiko tinggi, dan angka ini meningkat menjadi 18 orang pada tahun 2024. Tujuan penelitian ini adalah untuk mengidentifikasi faktor-faktor yang berhubungan dengan kejadian kehamilan berisiko tinggi, yang nantinya dapat dijadikan acuan dalam upaya pencegahan di wilayah Desa Sari Rejo. Jenis penelitian sebelumnya adalah penelitian kuantitatif dengan desain observasional analitis dan pendekatan cross-sectional. Hasil penelitian menunjukkan adanya hubungan signifikan antara usia ibu hamil (p=0,008), tingkat pendidikan (p=0,002), status gizi ibu (KEK) (p=0,037), dan kadar hemoglobin (HB) (p=0,004) dengan kejadian kehamilan berisiko tinggi di Desa Sari Rejo.

CONTINUOUS MIDWIFERY CARE IN A CASE OF GESTATIONAL HYPERTENSION AT PMB DEBY CYNTIA YUN, MEDAN CITY, NORTH SUMATRA

Thu, 08 Jan 2026 00:00:00 +0700

Hypertension in pregnancy is one of the leading causes of maternal mortality in Indonesia and remains a major public health problem (World Health Organization [WHO], 2023; Kementerian Kesehatan Republik Indonesia [Kemenkes RI], 2023). Inadequate management of gestational hypertension increases the risk of obstetric complications during pregnancy and childbirth (Prawirohardjo, 2020). The Continuity of Care (COC) approach is an effective strategy to prevent complications through comprehensive and continuous midwifery care (Varney et al., 2015). This study aims to describe the implementation of continuous midwifery care for Mrs. R with gestational hypertension at PMB Deby Cyntia Yun, Medan Amplas District, North Sumatra. This study used a descriptive case study design with a COC approach covering pregnancy, childbirth, postpartum, newborn care, and family planning, using Varney’s management framework and SOAP documentation (Varney et al., 2015). The results showed that Mrs. R experienced gestational hypertension starting at 32 weeks of gestation. Interventions included routine blood pressure monitoring, nutritional counseling, activity regulation, fetal well-being monitoring, and collaborative management when necessary (Prasetyowati, 2022). Labor occurred spontaneously without complications, while the postpartum period and neonatal condition progressed physiologically (Manuaba, 2019). Mrs. R chose a three-month injectable contraceptive method during the family planning phase (Kemenkes RI, 2022). In conclusion, the COC approach improves early detection of complications, strengthens health education, and supports safe decision-making from pregnancy through the postpartum period (Varney et al., 2015).

THE ROLE OF HEALTH WORKERS IN HANDLING CHOKING IN INFANTS IN THE WORKING AREA OF THE KAYU LAUT HEALTH CENTER, SOUTH PENYABUNGAN DISTRICT, MANDAILING NATAL REGENCY, NORTH SUMATRA PROVINCE YEAR 2024

Thu, 08 Jan 2026 00:00:00 +0700

According to data released by the World Health Organization (WHO) in , there were 17,537 cases of children under five years old (1-3 years old) who experienced choking. The main causes of this occurrence were food (59.5%) and foreign objects (31.4%), while 9.1% of the causes were unknown. In addition, the death rate due to choking in the UK also showed an increase. The main cause of choking is food stuck in the throat. According to data from the Office for National Statistics, there were 289 choking deaths in 2016, which represents an increase of 17% compared to the previous year. In the United States, 34 children were admitted to the emergency room due to choking on food. An estimated 12,435 children under the age of 14 are being treated in hospitals in the United States. The cause is choking on food due to the choking of formula milk or breast milk, sweets, meat, bones, fruits and vegetables. This research method is observational/survey using questionnaires or questionnaires without intervention. The type of research is descriptive analytics with cross-sectional. : the majority of health workers with Bachelor's Education were 16 people (48%) each and the minority of Diploma education was 3 people (9.0%). The majority of health workers were over 35 years old, with a total of 20 people or 61.0%. Meanwhile, health workers under the age of 35 amounted to 13 people or 39.0%. the majority of health workers have worked > 1 year as many as 26 people (79.0%) and minorities < 1 year as many as 7 people (21.0%). the majority of 18 people (55.0%) had 1 < training history and 15 people (45.0%) had a good or sufficient level of knowledge. Meanwhile, a small percentage of respondents, namely 8 people or 24.0%, have a lack of knowledge.

FACTORS INFLUENCING MOTHERS' SUPPLEMENTARY FOOD PROVISIONS TO INFANTS AGED 0-6 MONTHS IN THE ONOLALU PUBLIC HEALTH CENTER WORKING AREA, ONOLALU DISTRICT, NIAS REGENCY, 2023

Thu, 14 Aug 2025 00:00:00 +0700

While exclusive breastfeeding is the gold standard for infants under six months, the premature introduction of complementary foods (MP-ASI) remains a widespread practice. This research investigated the determinants of early supplementary feeding among mothers within the Onolalu Health Center’s jurisdiction in Nias Regency. Employing a descriptive quantitative method with a cross-sectional framework, the study surveyed 34 participants via total sampling. Statistical analysis using the chi-square test identified maternal knowledge and employment status as critical factors (p = 0.000 ). In contrast, the origin of information did not demonstrate a meaningful correlation (p = 0.173). These results suggest that healthcare practitioners must prioritize ongoing counseling to foster better understanding of breastfeeding protocols.

MANAGEMENT OF GERIATRIC NURSING CARE WITH SERVICE EXCELLENCE FOR MRS. Z WITH TYPE 1 DIABETES MELLITUS AT THE SOCIAL SERVICE CENTER FOR THE ELDERLY (UPTD) BINJAI

Thu, 14 Aug 2025 00:00:00 +0700

Diabetes Melitus Tipe 1 (T1DM) pada lansia menghadirkan tantangan kompleks karena penurunan fisiologis terkait usia dan peningkatan risiko komplikasi kronis. Pendekatan keperawatan geriatri yang berorientasi pada keunggulan layanan sangat penting untuk mengoptimalkan kualitas hidup dan hasil klinis bagi lansia di lingkungan perawatan residensial. Tujuan: Studi kasus ini bertujuan untuk menerapkan perawatan keperawatan komprehensif melalui pendekatan keunggulan layanan untuk Ibu Z (66 tahun) dengan Diabetes Melitus Tipe 1. Studi ini menggunakan desain studi kasus deskriptif di Pusat Pelayanan Sosial Lansia Binjai (UPTD), mengikuti proses keperawatan standar: asesmen holistik, diagnosis, perencanaan, implementasi, dan evaluasi. Diagnosis keperawatan utama yang diidentifikasi adalah ketidakstabilan kadar glukosa darah dan kurangnya pengetahuan tentang manajemen diet mandiri. Intervensi keunggulan layanan diintegrasikan melalui pendidikan kesehatan persuasif, pemantauan glukosa darah intensif, dan dukungan psikososial yang empatik. Setelah intervensi selama tiga hari, pasien menunjukkan peningkatan yang signifikan dalam literasi diet, dan kadar glukosa darah kapiler stabil dalam kisaran target. Penerapan perawatan keperawatan berbasis keunggulan layanan secara efektif meningkatkan kemandirian dan stabilitas klinis pasien lanjut usia dengan T1DM, sekaligus menumbuhkan rasa nyaman dan bermartabat dalam lingkungan layanan sosial.

CONTINUOUS OBSTETRIC CARE (CONTINUITY OF CARE) ON MRS. L WITH THE BREAST MILK DAM AT PMB BD. WANTI MEDAN DELI DISTRICT NORTH SUMATRA PROVINCE YEAR 2025

Thu, 08 Jan 2026 00:00:00 +0700

Maternal Mortality Rate (MMR) and Infant Mortality Rate (IMR) are critical health indicators. Perineal rupture is a significant cause of morbidity during childbirth, requiring proper management to prevent hemorrhage and infection. These risks can be mitigated through Continuity of Care (COC). To provide comprehensive midwifery care to Mrs. L, aged 26, covering the third trimester of pregnancy, delivery, newborn care, postpartum, and family planning, utilizing Varney’s management and SOAP documentation. This descriptive study with a case study approach was conducted at PMB Bd. Wanti S.Keb, Medan, in 2024. The subject was a third-trimester pregnant woman monitored through the postpartum period. During pregnancy, Mrs. L experienced physiological back pain, resolved through counseling and exercise. Spontaneous delivery occurred at 41 weeks. A second-degree perineal rupture involving the vaginal mucosa and muscles occurred during the second stage. Management involved continuous suturing and strict monitoring. The female baby was born vigorous with normal vital signs. Postpartum visits confirmed good uterine involution and successful lactation. Continuity of Care was successfully implemented. The management of the second-degree perineal rupture adhered to Normal Childbirth Care standards, effectively preventing complications like hemorrhage or infection.

MIDWIFERY CARE FOR MRS. R, WITH UMBILICAL CORD DELIVERY AT RIMENDA CLINIC, MEDAN DENAI DISTRICT, MEDAN CITY, NORTH SUMTRA PROVINCE IN 2025

Thu, 14 Aug 2025 00:00:00 +0700

Childbirth with an umbilical cord entanglement is a delivery carried out on a baby with an umbilical cord entanglement that can result in fatal consequences, namely death in the baby. This is due to repeated twisting of the umbilical cord in one direction, which can completely block fetal blood flow. Umbilical cord entanglement is usually found on the child’s neck. Several factors that cause umbilical cord entanglement include an umbilical cord that is too long, fetal movement that is too active, and a high volume of amniotic fluid. Umbilical cord entanglement refers to a condition where the umbilical cord is entangled in a part of the fetus’s body, such as the neck, body, or legs. WHO does not provide an explicit definition of this condition; medical literature states that umbilical cord entanglement is a common phenomenon in pregnancy and occurs in about 20-30% of pregnancies. Handling umbilical cord entanglement can be done by releasing it from the fetus's neck if possible; if not, the cord can be cut to reduce pressure. Perform medical treatment according to the safety of the mother and baby.

CONTINUITY OF CARE IN NY. F WITH MODERATE ANEMIA PREGNANCY INDEPENDENT PRACTICE MIDWIFE J. MANURUNG PERAK HAMPARAN DISTRICT KABUPATEN DELI SERDANG YEAR 2025

Thu, 08 Jan 2026 00:00:00 +0700

The problem in the case study is how to provide Midwifery Care to Mrs. F who experiences anemia in her pregnancy comprehensively, including Midwifery Care for pregnancy, childbirth, postpartum and family planning at PMB J. Manurung in 2025?. Implementing continuous obstetric care starting from pregnancy, childbirth, newborn, postpartum and family planning. From the results of research on sustainable care that has been given to Mrs. F starting from the third trimester, childbirth, postpartum and breastfeeding, newborns, to family planning which aims to improve the quality of midwifery services. After evaluation, data analysis according to the author's assumption Mrs. F With a pregnancy history of G3P2A0 with a gestational age of 28 weeks 2 days, the results were found from the examination that the fetus in the uterus (intrauterine), single, alive, the back is on the right side of the mother's abdomen, the presentation of the head, not yet in PAP, the condition of the mother and jani is in good condition. At the time of the study on Mrs. F, the author will conduct a comparison or suitability of research on the theory of obstetric management care in pregnant women, childbirth, postpartum childbirth, BBL, and family planning services and will be concluded on the results of the research that has been carried out.

EXCELLENT SERVICE NURSING CARE MANAGEMENT FOR CHILDREN WITH LEUKEMIA IN THE INTENSIVE CARE UNIT 4 AT H.ADAM MALIK GENERAL HOSPITAL MEDAN NORTH SUMATRA PROVINCE IN 2025

Thu, 14 Aug 2025 00:00:00 +0700

Acute lymphoblastic leukemia (ALL) is the most common type of blood cancer in children, significantly impacting their health status and quality of life. This study aims to evaluate nursing care in pediatric patients with ALL using a comprehensive nursing process approach. The research design is a descriptive case study involving one pediatric patient undergoing inpatient care at a hospital. Data were collected through interviews, observations, and documentation review. The primary nursing problems identified included ineffective peripheral tissue perfusion, activity intolerance, and risk of infection. Interventions focused on hemodynamic monitoring, pain management, and family education. The evaluation revealed clinical improvements and enhanced adaptive responses in the patient. This case study emphasizes the vital role of continuous and targeted nursing care in supporting the healing process and improving the quality of life in children with ALL

EXCELLENT SERVICE OF PSYCHIATRIC NURSING CARE MANAGEMENT AT MR. D WITH A GREAT REPUTATION AT THE PSYCHIATRIC HOSPITAL PROF. DR. MUHAMMAD ILDREM MEDAN NORTH SUMATRA PROVINCE YEAR 2025

Thu, 14 Aug 2025 00:00:00 +0700

Grandiose delusions are one of the common perceptual disturbances found in patients with schizophrenia, characterized by unrealistic beliefs about one's power or greatness. Managing this condition requires a professional, structured mental health nursing management approach that adheres to the principles of service excellence. This study aims to describe the management of mental health nursing care based on service excellence for Mr. D, who was treated at Prof. Dr. Muhammad Ildrem Mental Hospital in North Sumatra Province in 2025. The method used was a case study with a nursing process approach, including assessment, nursing diagnosis, planning, implementation, and evaluation. Interventions focused on therapeutic communication, reality therapy, and psychoeducation. The results of four days of nursing care showed a decrease in grandiose delusional behavior, improved thought processes, and content of thought more aligned with reality. The application of service excellence principles was evident through the nurse’s empathetic attitude, clear communication, timely interventions, and responsiveness to the client’s needs. The conclusion of this study indicates that mental health nursing management based on service excellence can improve the effectiveness of therapy and accelerate the recovery process in clients with grandiose delusions

THE ROLE OF HEALTH WORKERS IN PROVIDING PRE SECTIO CAESAREAN CARE FOR MATERNITY MOTHERS AT GRIYA HOSPITAL MEDICA BATAM IN 2024

Thu, 14 Aug 2025 00:00:00 +0700

Caesarean section is one of the most popular types of childbirth after a normal delivery. According to the WHO, the recommended standard of caesarean section in many countries is about 10–15% of total births. A 2021 WHO report revealed that caesarean section has become an increasingly common option, with a proportion reaching 21% of total deliveries globally. Basic Health Research data shows that SC surgeries account for 15.3% of the total surgical practices in all provinces in Indonesia. A survey conducted on mothers who gave birth in the last 5 years in 33 provinces revealed that in Central Java, SC surgery is the birth option for 77% of maternal mothers. The proportion of SC deliveries in Government Hospitals in Indonesia reaches around 20–25% of the total number of deliveries. Data shows that private hospitals have a higher percentage of SC deliveries, ranging from 30–80% of the total number of deliveries. The high rate of SC childbirth in Indonesia is caused by several factors, such as the SC childbirth process is suspected to be more not due to medical indications, but from patient demand. Method: This research method is observational/survey using questionnaires or questionnaires without intervention. The type of research is descriptive analytics with cross-sectional. Conclusion: The majority of health workers with bachelor’s and master’s/professional education are 16 people (46%) each and the minority of diploma education is 3 people (9%). The majority of health workers aged approximately 35 years are 22 people (63%) and the minority over 35 years old is 13 people (37%). The majority of health workers have worked for less than 1 year (80%) and minorities with less than 1 year of work are 7 people (20%). The majority of training history was approximately 1 time as many as 20 people (57%) and the minority of training history was 15 people (43%). Health workers with good knowledge as many as 25 people (71%) and minority knowledge as many as 3 people (9%). The majority of positive attitudes were 20 people (57%) and the minority of negative attitudes were 15 people (43%). The majority of skilled health workers are 25 people (71%) and the minority is unskilled as many as 10 people (29%).

CONTINUITY OF CARE IN MRS. R WITH MILD ANEMIA AT RIMENDA TARIGAN INPATIENT PRIMARY CLINIC, MEDAN POLONIA DISTRIC MEDAN CITY, NORTH SUMATRA PROVINCE IN 2025

Thu, 14 Aug 2025 00:00:00 +0700

Background: Continuity of Care (CoC) is a comprehensive midwifery service that establishes a continuous relationship between the midwife and the patient to ensure safety and quality of care. This approach is vital for reducing maternal mortality rates, which are significantly high during the postpartum period due to complications such as hemorrhage and infection. Objective: This study aims to provide comprehensive midwifery care to Mrs. Y, a 24-year-old, covering pregnancy, childbirth, postpartum, newborn, and family planning stages. Methods: A descriptive case study method was employed to systematically observe and document health phenomena related to the patient’s care at PMB Rimenda Tarigan in 2025. Data were collected through interviews, observations, and documentation using the SOAP approach and Helen Varney's 7-step management. Results: The pregnancy and labor (conducted on January 16, 2025) proceeded normally without serious complications. During the postpartum period, the patient experienced breast engorgement and low milk supply, which were successfully resolved through education on proper breastfeeding positions and breast care. The newborn showed no signs of infection or danger. For family planning, the patient chose the Lactational Amenorrhea Method (LAM). Conclusion: Comprehensive CoC successfully addressed physiological complaints and ensured the well-being of both mother and baby, emphasizing the importance of continuous midwifery support in lactation and reproductive health.

CONTINUOUS OBSTETRIC CARE (CONTINUITY OF CARE) IN NEWBORNS WITH MILD ASPHYXIA AT PRATAMA NIAR CLINIC MEDAN INDONESIA 2025

Thu, 14 Aug 2025 00:00:00 +0700

Neonatal asphyxia remains one of the leading causes of neonatal morbidity and mortality, particularly in developing countries. Timely and continuous obstetric care is essential to prevent complications and improve neonatal outcomes.(Kemenkes, 2023) Objective: This study aimed to describe the implementation of continuous obstetric care in a newborn with mild asphyxia at Pratama Niar Clinic, Medan. Methods: This study used a descriptive case study design conducted from November 2024 to February 2025. Data were collected through observation, interviews, physical examinations, and review of maternal and child health records. Care was provided continuously from antenatal, intrapartum, to postnatal periods. Results: The newborn experienced mild asphyxia associated with meconium-stained amniotic fluid and maternal factors.(Lee et al., 2025) .Immediate neonatal resuscitation followed by post-resuscitation care resulted in stable neonatal condition with a normal APGAR score. Continuous monitoring and early initiation of breastfeeding supported neonatal recovery. Conclusion: Continuous obstetric care enables early detection, prompt management, and effective prevention of complications in newborns with mild asphyxia. This approach contributes to improved neonatal outcomes and maternal understanding of pregnancy and childbirth risks.(Julyanti and Susilawati, 2024)

RELATIONSHIP BETWEEN MATERNAL AGE AND PARITY WITH THE INCIDENCE OF LOW BIRTH WEIGHT (LBW) BABIES AT MEDAN HAJI HOSPITAL

Thu, 14 Aug 2025 00:00:00 +0700

Background: The neonatal period is a critical period in a baby's life, lasting from birth to 28 days, during which the baby must adapt to the external environment and make physiological adjustments to survive. Women's reproductive age ranges from less than 20 to more than 35 years. Based on reproductive health guidelines, the safe age for pregnancy and childbirth is 20-35 years, while those under 20 or over 35 years are considered high-risk. Methods: This study used a cross-sectional design with a quantitative epidemiological approach. Data collected previously were used. This cross-sectional study design measures the relationship between risk factors or exposures and disease simultaneously. Results: The study found that five respondents (33.3%) experienced low birth weight (LBW) among primiparous mothers, 10 (66.7%) among multiparous mothers, and 10 (66.7%) among primiparous mothers, with four (23.5%) among multiparous mothers. Based on the chi-square test results in the Table above, the p-value was 0.014 (< 0.05); thus, Ha was accepted, and Ho was rejected. This indicates a significant relationship between age and the incidence of low birth weight (LBW) among pregnant women at RSU Haji Kota Medan in 2025.

ANALYSIS OF THE REFERRAL SYSTEM PROCESS IN MATERNAL AND NEONATAL EMERGENCIES IN THE WORKING AREA OF THE BEUTONG KEC HEALTH CENTER. THE CAB. THE NAME OF ACEH YEAR 2024

Thu, 14 Aug 2025 00:00:00 +0700

Maternal and child health is one of the focuses of the SDGsi, which globallyi still face complexi situations. Government policies aimed at reducing maternal and child mortality rates are implemented through health care programs for mothers and children, which are expected to meet targets and reach all beneficiaries (equity)i with high quality (quality). The 2023 Maternal and Child Health Survey (SKI 2023) aims to provide an up-to-date overview of the current state of maternali and child health, particularly neonates, to support efforts to reduce maternal and child mortality rates through more appropriate and effective strategies. Previous research conducted by Dinda Nestelita, Antono Suryoputro, and Wulan Kusumastuti stated that there is a relationship between the limited understanding of health workers regarding SOPs, communication between health workers and the referral information system of community health centers (puskesmas) with referral recipients (hospitals), which is less than optimal, as the dominant factor in implementing an optimal referral system. The research method used in this study is qualitative with a descriptive analytical approach and an observational design. Based on the above research, the data required is primary data obtained throughi ini-depthi interviewsi withi informantsi selected according to inclusion and exclusion criteria. The research wasi conductedi fromi Februaryi to Marchi 2024. Thei sample used in this study consisted of 8 health workers at the community health center and 1 pregnant woman in the Sultan Daulat sub-district. There are two criteria: inclusion criteria and exclusion criteria. The characteristics of the informants in the study show that almost all informants are female, with varying ages and positions ranging from 22 to 47 years old. The informants' educational backgrounds vary, with the majority holding a bachelor's degree, and the highest educational level being a nursing profession. Almost all informants work at the Beutong Health Center in Beutong District, Nagan Raya Regency, Aceh, as health workers, except for the ambulance drivers. The informants are also patients who underwent pregnancy examinations at the Beutong Health Center in Beutong District, Nagan Raya Regency, Aceh, and have undergone the referral process. Based on the above description, the researcher selected informants who met the predetermined criteria using purposive non-probability sampling.

THE INFLUENCE OF POSTPARTUM MOTHERS’ UNDERSTANDING OF BREAST CARE ON THE SUCCESS OF BREASTFEEDING AT FAHRINI AMIN CLINIC, BLANGPIDIE SUBDISTRICT, SOUTHWEST ACEH REGENCY, ACEH PROVINCE IN 2025

Thu, 14 Aug 2025 00:00:00 +0700

Perawatan payudara saat menyusui bertujuan untuk menjaga payudara tetap bersih dan mudah dihisap bayi. Oleh karena itu, perawatan payudara mencegah terjadinya infeksi payudara seperti mastitis (infeksi payudara). Penyakit infeksi yang paling sering terjadi pada payudara adalah mastitis puerperalis (Yupita, 2023). Berdasarkan data WHO (World Health Organization), 17.230.142 ibu di dunia mengalami masalah payudara saat menyusui. Terdapat sekitar (22,5%) ibu yang mengalami masalah pada puting, (18%) mengalami ASI yang tidak keluar secara normal atau tidak lancar, dan sekitar (38%) ibu mengalami pembengkakan dan nyeri pada payudara. Akibat dari masalah-masalah tersebut, bayi yang seharusnya mendapatkan ASI eksklusif tidak diperoleh, dan hanya diberikan susu formula (Rizal, 2022). Penelitian ini bertujuan untuk mengkaji pengaruh pengetahuan ibu nifas mengenai perawatan payudara terhadap keberhasilan menyusui di Klinik Fahrini Amin, Kecamatan Blangpidie, Kabupaten Aceh Barat Daya, Provinsi Aceh tahun 2025. Penelitian ini menggunakan pendekatan analitik observasional dengan rancangan single-group design dengan pengukuran dilakukan sebelum dan sesudah intervensi. Populasi dalam penelitian ini adalah seluruh ibu yang menjalani nifas setelah melahirkan di Klinik Fahrini Amin tahun 2025 yang berjumlah 30 orang. Pengambilan sampel dilakukan dengan teknik total sampling. Analisis data dilakukan dengan menggunakan uji-T berpasangan, untuk melihat ada tidaknya perbandingan data sebelum dan sesudah diberikan perhatian orang tua serta diperoleh selisih rerata antara pre-test dan post-test. Hasil penelitian menunjukkan bahwa pengetahuan ibu nifas mengenai perawatan payudara berpengaruh terhadap keberhasilan pemberian ASI di Klinik Fahrini Amin, Kecamatan Blangpidie, Kabupaten Aceh Barat Daya, Provinsi Aceh tahun 2025. Klinik Fahrini Amin diharapkan dapat memaksimalkan pengetahuan ibu nifas melalui promosi kesehatan tentang pentingnya perawatan payudara untuk menunjang kelancaran produksi ASI.

FACTORS AFFECTING SECOND AND THIRD TRIMESTER PREGNANT WOMEN’S READINESS FOR DELIVERY AT PMB SHINTA MEDAN JOHOR DISTRICT IN MEDAN CITY, NORTH SUMATRA PROVINCE IN 2025

Thu, 14 Aug 2025 00:00:00 +0700

One of reason height number death mother (AKB) and figures death baby (AKB) is unpreparedness Mother pregnant in face her delivery . This is can happen consequence delay handling moment happen complications childbirth in mothers . Readiness Mother in face labor can prevent occurrence complications in mother and baby with notice factor risks to the mother during the pregnancy process . There is readiness labor can done with prepare plan birth and preparation plan If occurs during labor mother . Purpose study This is identify and analyze factor affecting Mother pregnant in the second and third trimesters of pregnancy readiness childbirth . Sort of research This is a cross-sectional design and is quantitative and survey analytical. The study sample 32 women in their second and third trimesters who are moms were selected using purposive sampling. The inquiry This was put into practice in 2025 in PMB Shinta Medan City in the province of North Sumatra. Instrument studies employ questionnaires and apply the chi-squared statistical test to analyze data. According to the study's findings, 18 moms, or 56.3% of the total number of deliveries at PMB Shinta, are not prepared.There is significant relationship between knowledge mother ( p. value 0.047<0.05), parity Mother with p. value 0.029<0.05) and exposed information ( p. value 0.016<0.05). The conclusion is expected in mothers pregnant especially TM II and III so that they can prepare her delivery use prevent occurrence risk complications. Recommended for officer health can give Mother education health and motivation Mother pregnant in readiness mother during childbirth .

Keywords: Pregnant Women, Readiness , Childbirth , Parity, Knowledge

PERSUASIVE LEAFLET PROMOTION MEDIA AND ITS IMPACT ON KIDNEY HEALTH

Herry Prasetyo, Handoyo, Hartati Hartati; Dina Indarti DS — Fri, 29 Aug 2025 00:00:00 +0700

Background: Kidney health is greatly influenced by lifestyle, especially eating and drinking patterns. Lack of self-awareness in the student group due to practical and economic reasons, health education using persuasive leaflets is very important to be carried out to increase awareness and change healthy living behavior.

Research objective: To determine the use of promotional media in the form of persuasive leaflets in increasing compliance with kidney health behavior in students.

Method: This study used a pre-experimental design with a one group pretest-post-test approach. The subjects of the study were 45 students at one of the health colleges in the city of Purwokerto. The intervention was in the form of providing persuasive leaflets designed with the principles of visual communication and simple language. Data were analyzed using a paired t-test to see changes before and after the intervention.

Research results: There was an increase in compliance with kidney health behavior in the student group where before the intervention there were 21 people to only 5 people after the intervention. The level of correlation based on the paired t-test statistical test obtained a value of 0.64 which means it has a moderate correlation coefficient. The p value = 0.000 <0.005 indicates that there is a significant difference before and after the intervention

Conclusion and suggestion: Persuasive leaflet promotion media can influence student behavior to maintain kidney health. Students must continue to maintain healthy living behavior because they can be role models and agents of change in society.

THE RELATIONSHIP BETWEEN NUTRITIONAL STATUS AND WEIGHT GAIN OF PREGNANT WOMEN AT RUNDENG PUBLIC HEALTH CENTER SUBULUSSALAM CITY IN 2025

Irma Noviana, Ira Sanjaya, Ricca Nophia Amra, Rahayu Ningsih, Salimah Br Bancin — Mon, 18 Aug 2025 00:00:00 +0700

Nutritional status is a person's body condition that can be seen from the food consumed by the person while the nutritional status of pregnant women is the condition of the pregnant woman's body from consuming food and substances for survival. The purpose of this study is to determine "The Relationship Between Nutritional Status and Weight Gain of Pregnant Women at the Rundeng Health Center, Subulussalam City in 2025". Data obtained from Rundeng Village, Rundeng District, Subulussalam City in 2025 showed that the number of pregnant women was 45 people.

This study used correlational analytic methods with a cross-sectional approach using primary data. The population consisted of 45 pregnant women, and the sampling technique was total sampling. The study used a LiLA tape and a weight scale as measuring instruments.

Based on the results of the study after conducting a statistical test using the Chi-Square Test with a 95% confidence level on df 1 and the results of the statistical test calculations obtained p value = 0.000, so that the p value <0.05 so that it can be concluded that there is a relationship between nutritional status and weight gain of pregnant women at the Rundeng Health Center, Subulussalam City in 2025.

It is hoped that health workers can provide information about the benefits of conducting ANC regularly and routinely in subsequent pregnancies, as well as providing information to mothers to maintain the condition of subsequent pregnancies so that they remain healthy and maintain normal eating patterns.

THE RELATIONSHIP BETWEEN THE HABIT OF CONSUMING FOODS CONTAINING IRON WITH THE INCIDENCE OF ANEMIA IN PREGNANT WOMEN AT THE SULTAN DAULAT DISTRICT HEALTH CENTER IN 2025

Mon, 18 Aug 2025 00:00:00 +0700

Anemia in pregnancy is a major health problem in developing countries with high morbidity rates in pregnant women. The average pregnancy caused by anemia in Asia is estimated at 72.6%. The high prevalence of anemia in pregnant women is a problem currently being faced by the Indonesian government because it is related to morbidity and mortality in pregnant women. The purpose of this study was to determine the relationship between the habit of consuming foods containing iron and the incidence of anemia in pregnant women at the Sultan Daulat District Health Center. This type of research is an analytical survey study using a cross-sectional approach. The population of this study was all pregnant women who visited in January - December 2023 as many as 115 people. The sampling technique was purposive sampling with a sample size of 32 respondents. Data collection using questionnaires and Data analysis using the Chi-square test at a 95% confidence level. The results of the study obtained a pattern of habits of consuming foods containing iron, the majority of which were lacking as many as 20 people (62.5%) and the majority of pregnant women in the third trimester were anemic as many as 19 people (59.4%). The conclusion is that there is a significant relationship between the habit of consuming foods containing iron and the incidence of anemia in pregnant women at the Sultan Daulat District Health Center p-value = 0.001. Advice to pregnant women to maintain their intake of foods containing iron from vegetables, fish or meat every day to prevent anemia and pregnant women should consume iron tablets (Fe) during pregnancy regularly

SOCIAL MEDIA SUPPORT TO PREVENT POSTPARTUM DEPRESSION AND INCREASES ENDOGENOUS ENDORPHINS: A SYSTEMATIC REVIEW

dhea regita, Rima Muliani, Monica Bella Putri Utami — Sat, 20 Sep 2025 00:00:00 +0700

Perinatal depression affects around 13% of pregnant and postpartum women, with potentially serious consequences for their psychological health, relationships with close family and friends, and the health of their children. This review study aims to analyze the effectiveness of Social Media Support that is most recommended for preventing postpartum depression. This type of systematic review research uses searches from journal databases such as MEDLINE-Pubmed, Web of Science, Scopus and Science Direct. We use the PRISMA checklist as a guideline to ensure all steps are carried out correctly. A total of 410 records were identified through database searches, including 230 records from PubMed, 70 records from Scopus, and 110 records from ScienceDirect. Before screening, 45 duplicate records were removed, and 318 records were automatically excluded by screening tools due to ineligibility based on title, abstract, or format (e.g., non-scholarly sources or non-English language). Based on the relevant articles we reviewed in their entirety, we indicated that more than half of the women reported high support and illustrated the important role played by family, peers, and professionals as well as online and remote channels in providing postpartum informational and emotional support.

IMPLEMENTATION OF COMMUNITY NURSING CARE FOR HYPERTENSION AT THE KEDAI DURIAN PUBLIC HEALTH CENTER, MEDAN JOHOR DISTRICT NORTH SUMATERA PROVINCE IN 2025

Thu, 14 Aug 2025 00:00:00 +0700

Background: Hypertension is a global health burden, defined as blood pressure 140/90 mmHg by WHO. Global prevalence reaches 22%, with North Sumatra showing a high prevalence of 29.19%, yet medical diagnosis remains low. At Kedai Durian Health Center, 416 cases were recorded by April 2025. Objective: This study aims to provide comprehensive nursing care to elderly individuals with hypertension in the Kedai Durian Health Center service area, Medan Johor. Methods: A descriptive case study approach was utilized, following the nursing process: assessment, diagnosis, intervention planning, implementation, and evaluation. Results: The intervention led to an increase in the elderly’s knowledge regarding hypertension management, although the clinical problem was not fully resolved during the study period. Conclusion: Strengthening primary health care through the nursing process is essential for hypertension control in the elderly, specifically in improving health literacy.

EXCELLENT EMERGENCY NURSING CARE MANAGEMENT FOR MR. P WITH CHRONIC KIDNEY DISEASE IN ROOM RA 6, H. ADAM MALIK GENERAL HOSPITAL, NORTH SUMATERA PROVINCE, 2025

Thu, 14 Aug 2025 00:00:00 +0700

Chronic Kidney Disease (CKD) is a medical condition characterized by a gradual decline in kidney function over a period of at least three monts. This disorder causes the kidneys to become ineffective at filtering blood, leading to the accumulation of metabolic waste prodycts in the body. CKD is progressive and can lead to multisystem complications, especially in the end stages, which require renal replacement therapy such as hemodialysis. Some of the main risk factors for CKD include diabetes mellitus, hypertension, heart disease, and a family history of kidney disease. Globally, CKD is a non-communicable disease with high morbidity and mortality rates. In Indonesia, the prevalence of CKD increases annually, including at H. Adam Malik General Hospital, Medan. Based on medical records, in 2023, there were 619 hospitalizations and 184 cases in the adult ICU. Meanwhile, in 2024, there was an increase to 714 hospitalizations and 239 cases in the adult ICU. This data indicates a significant upward trend and is a concern in nursing services, particularly in emergency care.Based on this background, the author is interested in presenting a case study on service excellence-based emergency nursing care management for patients with CKD.

CONTINUITY OF MIDWIFERY CARE FOR A PREGNANT WOMAN WITH FIRST-DEGREE PERINEAL LACERATION AT RIMENDA TARIGAN CLINIC, MEDAN DENAI SUB-DISTRICT, MEDAN CITY, NORTH SUMATRA PROVINCE, YEAR 2025

Thu, 14 Aug 2025 00:00:00 +0700

Maternal health is a key priority in improving overall public health. Indonesia has a high maternal mortality rate (MMR) of 305 deaths per 100,000 live births, largely due to postpartum hemorrhage. One contributing factor is perineal rupture, which affects 75% of vaginal births. WHO reports 2.7 million global cases, with projections reaching 6.3 million by 2050. To reduce the MMR to 70 by 2030, in line with the SDGs, the Indonesian government is working to improve women and children's health services. First-degree perineal lacerations, often caused by spontaneous tears or episiotomy, are manageable by midwives under existing health regulations. Midwifery care must be systematic, starting from data collection to problem identification, followed by planning, action, and evaluation using methods like SOAP and the Helen Varney model. The Continuity of Care (CoC) model supports integrated care across healthcare facilities—from pregnancy to postpartum—helping reduce maternal mortality and improve outcomes for both mothers and babies.

CONTINUITY OF CARE MANAGEMENT IN NY. R WITH RUPTURE OF THE PERINEUM DEGREE I AT PMB MIDWIFE WANTI MEDAN CITY

Thu, 14 Aug 2025 00:00:00 +0700

Rupture of the perineum is a common complication in childbirth that can increase the risk of infection and postpartum maternal morbidity. Rupture of the perineum occurs due to maternal factors (parity, birth distance, and infant weight), improper delivery and past labor history. Rupture of the perineum has its own impact on the mother which is one of the causes of complications during the postpartum period until death. This study aims to describe the continuity of care (COC) in Mrs. R who experienced a perineal rupture of the first degree at PMB Midwife Wanti, Medan Deli District. A healthy Indonesia is one of the targets for social transformation for the 2045 golden program, which is Indonesia's goal to become a developed, sovereign, and sustainable country by 2045, improving quality. There are 60% of cases of mothers giving birth experiencing perineal tears which result in bleeding and infectionsafter childbirth, while in Indonesia out of 26 million mothers giving birth, 40% of mothers experience rupture perineumThe research was conducted through a case study approach with service stages that include pregnancy, childbirth, postpartum period, newborn (BBL), and family planning (KB). This type of research is qualitative descriptive through a case study approach. The subject of the study was Mrs. R, a primigravida mother who underwent care from pregnancy to birth control at PMB Wanti. Data was collected through interviews, observations, physical examinations, and SOAP documentation. The intervention was structured based on Varney's seven-step midwifery care management. The results show that the systematic implementation of COC care can improve the quality of services and accelerate the recovery of postpartum mothers. Evidence-based interventions such as personal hygiene, nutrition education, and psychological support have been shown to be effective in supporting the healing of perineal wounds and maternal readiness during postpartum and breastfeeding.

EXCELLENT MEDICAL-SURGICAL NURSING CARE MANAGEMENT FOR MRS. H WITH PULMONARY TB IN THE PULMONARY INPATIENT WARD, H. ADAM MALIK GENERAL HOSPITAL, MEDAN CITY

Thu, 14 Aug 2025 00:00:00 +0700

Pulmonary tuberculosis (TB) remains a major infectious disease and a serious public health problem in both Indonesia and globally. According to WHO data in 2024, Indonesia ranks second after India among countries with the highest tuberculosis burden. Globally, it is estimated that in 2023 there were 10.6 million new TB cases, with approximately 1.3 million deaths among HIV-negative individuals. Indonesia contributed around 10% of the global burden, with an estimated 1,060,000 cases and an incidence rate of 385 per 100,000 population. Pulmonary tuberculosis is an infectious disease that attacks the lungs, typically characterized by persistent cough, shortness of breath, and significant weight loss.This final report aims to describe the management of medical-surgical nursing care focused on "service excellent" principles for a patient with tuberculosis, identified as Mrs. H, who was hospitalized in the pulmonary ward of H. Adam Malik General Hospital, Medan, in 2025. The method used is a case study with a descriptive approach. Data were collected through interviews, direct observations, and review of medical records. The assessment revealed that Mrs. H complained of a persistent productive cough for two months, shortness of breath, decreased appetite, and severe weight loss from 45 kg to 33 kg. The established nursing diagnoses included ineffective airway clearance, impaired gas exchange, and nutritional deficits. Nursing interventions focused on airway management, oxygen therapy, and nutritional management. The implementation of care was carried out over three days, with ongoing evaluation using the SOAP method. The evaluations showed gradual improvements, although not yet fully resolved, thus requiring continued intervention by the ward nursing staff. The implementation of medical-surgical nursing care with a service excellent approach emphasizes patient-centered care, effective communication, comprehensive education, and multidisciplinary collaboration to achieve optimal outcomes. Nurses are expected to support patient recovery, prevent further complications, and improve quality of life through professional, empathetic, and humanistic services. This report is expected to contribute to the development of nursing science, particularly in infectious pulmonary disease management. Furthermore, it can serve as a reference for hospitals to improve the quality of nursing care according to standards and strengthen the role of nurses as the frontline in tuberculosis prevention and management.

CONTINUITY OF CARE IN MRS. T WITH BREAST MILK DAM AT THE BUNDA CLINICNIETA DELI SERDANG REGENCY PROVINCE NORTH SUMATRA IN 2024

Thu, 14 Aug 2025 00:00:00 +0700

Basically, in health development in Indonesia, it aims to increase awareness, willingness and ability to live a healthy life for everyone so that Indonesia's health is achieved as high as possible. The Maternal Mortality Rate (MMR) in Indonesia is still very high from the global SDGs to reduce the MMR to 183,000 per 100,000 KH in 2014. Seeing this condition, strategic and comprehensive efforts are needed to achieve reducing the AKI to 183 per 100,000 KH by 2030 and a reduction in mortality of at least 5.5% per year is needed (Permenkes No. 21 of 2020). The maternal mortality rate (MMR) in 2021 is 7,389 people in Indonesia. The increase in maternal mortality rate (AKI) is high after compared to the previous 2020. Where the maternal mortality rate (AKI) is 4,627 people in Indonesia. (Indonesian Health Profile 2021). From the province of North Sumatra during 2020, the number of deaths reached 187 cases from 299.98 birth targets from the number of infant deaths of 751 cases from 198 live birth targets (Indonesian Health Profile 2020).

SCIENTIFIC WRITING ON GERIATRIC NURSING MANAGEMENT WITH SERVICE EXCELLENCE FOR MRS. Z WITH HYPERTENSION AT THE ELDERLY SOCIAL SERVICE UNIT IN BINJAI, NORTH SUMATRA PROVINCE YEAR 2025

Thu, 14 Aug 2025 00:00:00 +0700

Hypertension is one of the most common non-communicable diseases among the elderly and a leading cause of increased morbidity and mortality. In the context of gerontic nursing care, nurses play a crucial role in providing comprehensive and continuous care to improve the quality of life of older adults. This study aims to describe gerontic nursing care that prioritizes the principles of service excellence in managing hypertension in Mrs. Z, an elderly resident at the UPTD Elderly Social Service Binjai. The method used was a descriptive case study involving assessment, diagnosis, intervention, implementation, and evaluation stages. The results showed that non-pharmacological interventions, such as deep breathing relaxation techniques and hypertension exercises, effectively reduced pain complaints, improved physical activity, and enhanced Mrs. Z's quality of life. The application of service excellence principles—professionalism, accountability, collaboration, empathy, and reliability—also strengthened the quality of nursing services provided. In conclusion, gerontic nursing care management based on service excellence is effective in addressing hypertension in the elderly and aligns with the achievement of SDGs points 3 and 4

Management of Geriatric Nursing Care with Service Excellent for Mr. N with Xerosis Cutis at the Social Elderly Service Unit (UPTD) Binjai North Sumatra Province 2025

Thu, 14 Aug 2025 00:00:00 +0700

Latar Belakang: Xerosis cutis, atau kulit kering, merupakan masalah kesehatan umum di kalangan lansia akibat perubahan fisiologis pada sistem integumen. Kondisi ini dapat menyebabkan ketidaknyamanan, gangguan tidur, dan bahkan penurunan kualitas hidup. Survei awal di UPTD Pelayanan Sosial Lansia di Binjai menunjukkan bahwa 13,5% dari 198 penghuni lansia mengalami gangguan kulit, termasuk xerosis cutis. Tujuan: Studi ini bertujuan untuk mendeskripsikan manajemen perawatan keperawatan gerontologi dengan pelayanan prima untuk Bapak N dengan xerosis cutis di UPTD Pelayanan Sosial Lansia di Binjai, Provinsi Sumatera Utara, pada tahun 2025. Metode: Studi ini merupakan studi kasus menggunakan pendekatan perawatan keperawatan terstruktur yang meliputi enam tahapan: asesmen, diagnosis keperawatan, intervensi, implementasi, evaluasi, dan dokumentasi. Data dikumpulkan melalui observasi, wawancara, dan pemeriksaan fisik. Hasil: Perawatan keperawatan yang diberikan, termasuk perawatan kulit yang terfokus, edukasi tentang kebersihan pribadi, dan penggunaan emolien secara rutin, membantu mengurangi gejala xerosis pada Tn. N. Intervensi keperawatan berkontribusi pada peningkatan kenyamanan, peningkatan kepercayaan diri, dan peningkatan kualitas hidup. Kesimpulan: Perawatan keperawatan yang terstruktur dan berbasis kebutuhan dengan menggunakan pendekatan gerontologis efektif dalam mengelola xerosis cutis. Pendekatan ini diharapkan dapat menjadi acuan untuk memberikan layanan keperawatan yang optimal dan berkualitas tinggi bagi lansia di lembaga sosial.

THE INFLUENCE OF EDUCATION USING QUARTET CARD MEDIA ON KNOWLEDGE ABOUT TEENAGE PREGNANCY

Thu, 14 Aug 2025 00:00:00 +0700

Latar Belakang: Kehamilan remaja merupakan fenomena internasional yang masih belum terselesaikan. Berdasarkan hasil Penelitian Kesehatan Dasar (2018), proporsi remaja usia 10-19 tahun yang pernah hamil adalah 58,8 persen dan yang sedang hamil anak pertama adalah 25,2 persen, rata-rata usia ibu yang hamil pertama kali adalah 18 tahun, yaitu 46 persen, di mana terdapat perbedaan angka di daerah pedesaan yang lebih tinggi (51 persen) dibandingkan daerah perkotaan. Hasil Survei Demografi dan Kesehatan (SDKI) Indonesia (2017) menunjukkan bahwa 7 persen perempuan usia 15-19 tahun telah menjadi ibu, 5 persen telah melahirkan dan 2 persen sedang hamil anak pertama. Tujuan: Mengevaluasi pengaruh pendidikan menggunakan media kartu kuartet terhadap pengetahuan tentang kehamilan remaja di SMA Negeri 1 Bintang Bayu, Kecamatan Bintang Bayu, Kabupaten Serdang Bedagai pada tahun 2024. Metode: Penelitian ini menggunakan metode quasi-eksperimen dengan desain Pretest-Post test dengan desain kelompok kontrol. Populasi dalam penelitian ini adalah seluruh remaja di SMA Negeri 1 Bintang Bayu, Kecamatan Bintang Bayu, Kabupaten Serdang Bedagai, kelas X dan X1 berjumlah 157 orang. Ukuran sampel penelitian menggunakan rumus Lemeshow, yaitu 30 orang. Lokasi penelitian dilakukan di SMA Negeri 1 Bintang Bayu, Kecamatan Bintang Bayu, Kabupaten Serdang Bedagai, dan dilaksanakan pada bulan Mei-Juni 2024. Hasil: Hasil uji statistik dengan uji Mann-Whitney menunjukkan nilai P = 0,000 yang berarti p < 0,05. Kesimpulan: Terdapat pengaruh pendidikan menggunakan media kartu berganda terhadap pengetahuan tentang kehamilan remaja di SMA Negeri 1 Bintang Bayu, Kecamatan Bintang Bayu, Kabupaten Serdang Bedagai. Diharapkan akan ada kerja sama dengan petugas kesehatan dalam memberikan pendidikan menggunakan media kartu berganda mengenai pengetahuan tentang kehamilan remaja.

EXCELLENT GERMANY NURSING CARE MANAGEMENT FOR Mrs. S WITH TYPE 2 DIABETES MELLITUS AT THE SOCIAL SERVICES UPTD FOR THE ELDERLY IN BINJAI NORTH SUMATRA PROVINCE SOCIAL SERVICES DEPARTMENT 2025

Thu, 14 Aug 2025 00:00:00 +0700

Type 2 Diabetes Mellitus (T2DM) is a degenerative disease whose prevalence continues to increase from year to year in various countries around the world. This disease is better known by the public as "diabetes" and is characterized by increased blood sugar levels (hyperglycemia) which are fluctuating and tend to persist for a long time, especially after eating. Objective: To provide geriatric nursing care for patients with type 2 diabetes mellitus at the Elderly Service Unit of the Binjai Social Service, North Sumatra Province. Method: This study uses a case study design with a qualitative descriptive approach. Subject: The study used one elderly patient with type 2 diabetes mellitus. Data collection was carried out through various methods, namely interviews, direct observation of the patient's condition, and physical examination to obtain a more accurate picture of the patient's condition. Results: Based on the results of the assessment that has been carried out, four nursing diagnoses were found that can be established, including: Instability of blood glucose levels, Sleep pattern disorders, Skin integrity disorders. Interventions carried out with health education about diabetes mellitus, Teaching diabetes foot exercises, using lotion. Evaluation showed significant improvements in the physical and psychological parameters of patients. Conclusion: Health education carried out can increase success in providing nursing care with diabetes mellitus

MANAGEMENT OF GERONTIC NURSING CARE WITH SERVICE EXCELLENT FOR MR. J WITH ATOPIC DERMATITIS AT THE BINJAI SOCIAL SERVICES FOR THE ELDERLY DEPARTEMENT OF SOCIAL SERVICES NORTH SUMATRA PROVINCE IN 2025

Thu, 14 Aug 2025 00:00:00 +0700

Atopic dermatitis is a chronic inflammatory skin condition that commonly affects elderly individuals due to age-related immune decline and suboptimal personal hygiene practices. This condition not only causes significant discomfort but can also lead to complications that impact the quality of life in older adults. In the Binjai Elderly Social Service Unit (UPTD), North Sumatra, 8 out of 198 residents (4.04%) were reported to have symptoms consistent with atopic dermatitis. Among these, Mr. J, a 65-year-old resident, presented with notable clinical features such as persistent itching, skin lesions due to scratching, dry skin, and disturbed sleep patterns. To address this issue, a comprehensive geriatric nursing care management plan was implemented using a service excellent approach, aimed at improving patient comfort and promoting effective self-care. The study employed a descriptive case study method conducted from March to April 2025, using direct interviews, observations, physical examinations, and documentation to gather data. Through the nursing process—assessment, diagnosis, planning, implementation, and evaluation—the nursing team identified three primary problems: impaired skin integrity, discomfort due to itching, and a deficit in self-care. Interventions included the use of emollients, administration of topical hydrocortisone cream, education on personal hygiene, and strategies to encourage patient motivation and independence in daily care. The outcomes demonstrated a marked improvement in skin condition, reduction in itching, improved sleep quality, and increased awareness and participation in personal hygiene practices. This case study highlights the critical role of nurses in delivering holistic, patient-centered care to elderly individuals suffering from atopic dermatitis. A service excellent approach, grounded in empathy, education, and evidence-based interventions, proves to be a powerful model in managing chronic skin conditions in geriatric settings.

CONTINUOUS MIDWIFERY CARE (CONTINUITY OF CARE) ON NY.L WITH MILD ANEMIA IN THE CLINIC PRATAMA NIAR, MEDAN AMPLAS KOTA DISTRICT MEDAN NORTH SUMATRA IN 2025

Thu, 14 Aug 2025 00:00:00 +0700

Anemia is characterized by a deficiency in circulating erythrocytes or hemoglobin levels, which compromises the blood's capacity to transport essential oxygen to bodily tissues. As outlined by Proverawati (2020), this clinical state is defined by gender-specific thresholds: hemoglobin concentrations falling below 13.5 g/dL in men and 12.0 g/dL in women. Furthermore, Varney (2019) specifies that for the pregnant population, a reading under 12.0 g/dL is indicative of anemia. It is estimated that iron deficiency serves as the primary etiology in these cases, accounting for nearly 95% of all gestational anemia occurrences.Anemia is characterized by a deficiency in circulating erythrocytes or hemoglobin levels, which compromises the blood's capacity to transport essential oxygen to bodily tissues. As outlined by Proverawati (2020), this clinical state is defined by gender-specific thresholds: hemoglobin concentrations falling below 13.5 g/dL in men and 12.0 g/dL in women. Furthermore, Varney (2019) specifies that for the pregnant population, a reading under 12.0 g/dL is indicative of anemia. It is estimated that iron deficiency serves as the primary etiology in these cases, accounting for nearly 95% of all gestational anemia occurrences.

CONTINUITY OF CARE IN FOR MRS. I WITH SECOND-DEGREE PERINEAL RUPTURE AT THE HEALTHY MIDWIFE CLINIC, SIDAMANIK DISTRICT

Thu, 14 Aug 2025 00:00:00 +0700

Perawatan berkelanjutan (KK) adalah upaya untuk memberikan perawatan berkelanjutan mulai dari kehamilan, persalinan, pascapersalinan, bayi baru lahir, dan keluarga berencana, pengobatan bertujuan untuk memantau kondisi ibu dan bayi sebagai upaya untuk mengurangi Angka Kematian Ibu (KKK) dan Angka Kematian Bayi (KKK) (Yulinda 2019). Pengobatan ini dilakukan untuk melaksanakan perawatan kebidanan secara berkelanjutan bagi ibu hamil, persalinan, pascapersalinan, bayi baru lahir, dan keluarga berencana secara komprehensif dari Klinik Pratama Niar, Medan Sand, Kota Medan dengan mengambil pendekatan manajemen perawatan kebidanan sesuai dengan standar kebidanan. Angka kematian ibu (KKK) disebabkan oleh beberapa komplikasi selama dan setelah kehamilan dan persalinan, 75% kematian ibu disebabkan oleh perdarahan, tekanan darah tinggi, infeksi selama kehamilan, komplikasi persalinan seperti aborsi tidak aman, juga disebabkan oleh kondisi kronis seperti penyakit maag dan diabetes. Angka kematian ibu (KKK) global adalah 303/100.000 kelahiran hidup dan angka kematian bayi (KKK) adalah 41/1.000 kelahiran hidup. WHO mencatat angka kematian ibu (KMA) di dunia sebesar 303.000, sedangkan KMA di ASEAN adalah 235 per 100.000 kelahiran hidup. Menurut data Survei Demografi dan Kesehatan Indonesia, KMA adalah 305 per 100.000 kelahiran hidup dan KMA adalah 24 per 1.000 kelahiran hidup. Jumlah kematian ibu di Indonesia pada tahun 2020 adalah 4.627 jiwa dan pada tahun 2021 jumlah kematian ibu meningkat menjadi 7.389 jiwa.

CONTINUITY OF CARE IN NY. S AGE 34 YEARS OLD WITH MILD ANEMIA DIPMB HAMIDAH, KEC. MEDAN MAIMUN, MEDAN CITY, NORTH SUMATRA IN 2025

Wed, 07 Jan 2026 00:00:00 +0700

Anemia is a condition in which the number of red blood cells (erythrocytes) or the level of hemoglobin (Hb) in the blood is insufficient for the body's physiological needs. This study focuses on the relationship between education level and anemia cases in pregnant women. The main cause of anemia is due to pregnant women lacking iron intake, vit D, vit B12, lack of blood cells. (Saras, 2023) This case study describes the treatment of anemia in a 34-year-old pregnant woman with a gestation of 38 weeks and 5 days. The care provided includes the provision of FE tablets and providing nutritious food-related kie and encouraging frequent visits to ANC The purpose of this service is to increase the understanding of pregnant women about the prevention and treatment of anemia in the research area at Pmb Hamidah. ( Squirt & Lestarini , 2024) The method used in this service is education and the administration of Fe tablets. The results of this activity showed an increase in pregnant women's knowledge about anemia and how to prevent anemia. In conclusion, education and intervention in administering Fe tablets in handling cases in this region.(WHO, 2023)

MATERNITY NURSING CARE MANAGEMENT WITH SERVICE EXCELLENCE FOR Mrs. R WITH SECOND TRIMESTER ANEMIA AT PERA CLINIC, MEDAN TUNTUNGAN SUB-DISTRICT NORTH SUMATRA PROVINCE

Thu, 14 Aug 2025 00:00:00 +0700

Anemia selama kehamilan tetap menjadi masalah kesehatan ibu yang serius di Indonesia, yang berkontribusi pada komplikasi seperti persalinan prematur, perdarahan pascapersalinan, berat badan lahir rendah, dan bahkan kematian ibu dan bayi baru lahir. Menurut data WHO tahun 2023, prevalensi anemia global adalah 40% pada anak usia 6–59 bulan, 37% pada ibu hamil, dan 30% pada wanita usia 15–49 tahun. Di Asia, prevalensi anemia terkait kehamilan mencapai 49,4%. Di Indonesia, angka kejadiannya meningkat dari 37,1% pada tahun 2013 menjadi 48,9% pada tahun 2018, dengan prevalensi tertinggi ditemukan pada kelompok usia 15–24 tahun yaitu 84,6%. Laporan Riskesdas 2021 menyebutkan bahwa 78% ibu hamil di Indonesia mengalami anemia, dan di Provinsi Sumatera Utara, prevalensinya berkisar antara 15% hingga 39%. Studi kasus ini bertujuan untuk mengimplementasikan manajemen perawatan keperawatan maternitas dengan pendekatan pelayanan prima pada Ibu R, seorang ibu hamil trimester kedua yang didiagnosis menderita anemia di Klinik Pera, Kecamatan Medan Tuntungan. Studi ini menggunakan metode studi kasus deskriptif dengan pendekatan proses perawatan keperawatan yang meliputi asesmen, diagnosis, intervensi, implementasi, dan evaluasi. Asesmen menunjukkan bahwa Ibu R menunjukkan gejala anemia tipikal dengan kadar hemoglobin 9 g/dl. Intervensi difokuskan pada edukasi gizi, pemantauan tanda vital, peningkatan perfusi jaringan, dan pemberian dukungan emosional. Evaluasi menunjukkan perbaikan klinis baik pada kondisi fisik maupun psikologis. Hasil studi ini menunjukkan bahwa penerapan perawatan keperawatan profesional dengan fokus pada pelayanan prima dapat meningkatkan kualitas hidup ibu hamil dan mendukung upaya untuk mengurangi prevalensi anemia terkait kehamilan.

MATERNITY NURSING CARE MANAGEMENT SERVICE EXCELLENCE FOR MRS. H WITH FIRST TRIMESTER HYPEREMESIS GRAVIDARUM AT SANTI MELIALA CLINIC MEDAN POLONIA SUB-DISTRICT, NORTH SUMATRA PROVINCE YEAR 2025

Wed, 07 Jan 2026 00:00:00 +0700

Hyperemesis gravidarum is a pregnancy complication characterized by persistent, severe nausea and vomiting, which can lead to weight loss of more than 5% of pre-pregnancy weight, dehydration, acid-base imbalance, and hypokalemia. According to 2021 World Health Organization (WHO) data, the incidence of hyperemesis gravidarum reached 12.5% of all pregnancies worldwide, and its prevalence tends to increase to 15%. Data from the Santi Meliala Inpatient Primary Clinic shows an increase in the number of cases from 85 patients in 2023 to 90 patients in 2024. This study aims to implement excellent service-oriented maternity nursing care managemen whot for Mrs. H with first-trimester hyperemesis gravidarum. A case study approach was used in this study, covering the stages of assessment, diagnosis, intervention, implementation, and evaluation of nursing care. The results obtained indicate that Mrs. H's nausea and vomiting symptoms were successfully resolved through the implementation of appropriate interventions and holistic and professional nursing services. By implementing excellent service, the quality of nursing care for patients with hyperemesis gravidarum can be improved, thereby helping to accelerate the recovery process and increase patient satisfaction with healthcare services.(WHO, 2023)( Minister of Health Regulation , 2021)

LOW BIRTH WEIGHT IN TWIN BABIES: CASE STUDY AND CLINICAL MANAGEMENT

Wed, 07 Jan 2026 00:00:00 +0700

Twin pregnancies are inherently high-risk gestations frequently associated with Low Birth Weight (LBW) due to uterine capacity limits and nutrient competition. LBW remains a primary contributor to neonatal morbidity and mortality globally, including in Indonesia. Objective: This study aims to evaluate the implementation of integrated midwifery care using the 7-step Helen Varney framework in managing twin neonates with LBW to optimize clinical outcomes. A qualitative descriptive case study was conducted on a 30-year-old multigravida mother and her twin neonates born at $36^{+4}$ weeks of gestation. Data were collected through longitudinal observation, physical examinations, and semi-structured interviews. Clinical management followed the systematic Helen Varney framework, benchmarking outcomes against national neonatal care standards. Baby A (2100g) and Baby B (1900g) were born with high vitality (Apgar scores 8-10) despite their LBW status. The primary etiologies identified were maternal nutritional deficits and placental insufficiency. Immediate interventions, including thermal regulation, Vitamin K prophylaxis, and early initiation of exclusive breastfeeding, resulted in steady weight gain and the absence of postnatal complications. Conclusion: Integrated midwifery care and the Continuity of Care (CoC) model are essential in mitigating the risks associated with twin LBW. Standardizing systematic frameworks in primary healthcare settings can significantly improve neonatal survival and long-term growth trajectories.

Health Education Fluor Albus (Keputihan) In Pregnant Women With Excellent Education Services At PMB Shinta Medan Polonia In 2024

Wed, 07 Jan 2026 00:00:00 +0700

ABSTRACT

Background: Fluorus albus (vaginal discharge) is white fluid that comes out of the sexual canal in excess. Fluorus albus is a vaginal fluid, not blood. During pregnancy, vaginal discharge increasesin quantity. According to the World Health Organization (WHO), recommendations in America that reproductive health problems include 31.6% of pregnant women experiencing vaginal discharge (fluor albus) caused by the fungus Candida albican. In Indonesia, the problem of vaginal discharge is increasing, with more than 75% of women experiencing vaginal discharge due to the humid temperature in Indonesia, making them easily infected.candida albicans fungus, parasites such as pinworms or germs (trichomonas vaginalis) According to data from the 2019 North Sumatra Province Health Profile, there wer 648,829 pregnant women in 2019, 1,566 cases of pregnant women experiencing vaginal discharge, in the city of Medan in 2019 there were 855,281 people and 45% had experienced vaginal discharge . Method: This activity begins with the preparation, implementation and evaluation stages. Results: 15 participants in this activity were pregnant women who visited PMB Shinta in Medan Polonia, Medan City. In its implementation, it was explained that the genital organ problem that pregnant women often experience, especially in the third trimester, is fluoride albus (vaginal discharge). The types of vaginal discharge also need to be understood as well as the treatment and therapy that needs to be given to pregnant women in preventing and treating cases of Fluor Albus. Conclusion: The results obtained from this community service activity are an increase in knowledge about preventing vaginal discharge and the treatment that will be carried out if complications occur. Pregnant women whoexperience vaginal discharge will pose a risk to the health and growth and development of their fetus later. The risk of vaginal discharge before and after was an increase of 15% for the good level of knowledge, and 27% for the sufficient level, and at the level of poor knowledge it decreased by 40%. With this change in the level of knowledge and strengthening understanding of Fluor Albus, it is hoped that pregnant women will be more aware of the conditions of their pregnancy, especially in maintaining personal hygiene which will result in disruption of fetal growth and development. Conclusion: The results obtained from this community service activity are an increase in knowledge about preventing vaginal discharge and the treatment that will be becarried out if complications occur. Pregnant women who experience vaginal discharge will pose a risk to the health and growth and development of their fetus later. The risk of vaginal discharge before and after was 15% increased for the good level of knowledge, and 27% for the sufficient level, and for the poor knowledge level it decreased by 40%. (WHO, 2023) (Health Office Province North Sumatra, 2020) ( Friza Shirley Srivastava Situmorang et al., 2024a)

CONTINUOUS MIDWIFERY CARE (continuity Of Care) IN NY. W WITH BREAST MILK DAM IN CLINIC PRATAMA SARFINA KEC. KOTA MEDAN YEAR 2025

Wed, 07 Jan 2026 00:00:00 +0700

ABSTRACT

Breast milk dam is an event in which the venous and lymphatic flow is obstructed, the milk flow becomes obstructed and the pressure on the milk ducts and alveoli increases. This event is caused by the collected milk not being removed so that it becomes a blockage. Indications that often arise in breast milk dams include swollen breasts, breasts feeling hot and hard and the mother's body temperature up to 38.C. if the breast dam continues, it will cause mastitis and breast abscesses. The cause of breast milk dams is mostly postpartum mothers, the feeling of fullness and heaviness in the breasts due to swelling can be passed without becoming a significant problem, especially if the baby breastfeeds with lancer. But if what happens is that the production of breast milk exceeds the ability of the breast to store the milk, then it can cause the breast to feel hard, full and cause discomfort, this event is called a milk dam. This case study describes the handling of breast milk dams in 39-year-old postpartum mothers with Grafida P3 A0. The care provided includes doing breast care and providing brascare measures. The research method used in this study is education and breast care measures for prevention

RISK FACTORS FOR HYPERTENSION DURING PREGNANCY AT THE MOTHER RINI CLINIC, SUNGGAL DISTRICT, MEDAN CITY NORTH SUMATRA PROVINCE 2024

Thu, 14 Aug 2025 00:00:00 +0700

Introduction: Hypertension in pregnancy is a very dangerous condition if it occurs in pregnant women because it can cause preeclampsia, preterm birth, fetal growth disorders, respiratory syndrome and fetal death. Objective: to analyze the incidence of hypertension in pregnancy at the Bunda Rini Clinic in 2024. Population and Sample: all pregnant women who came to visit the Bunda Rini Clinic during 2023 as many as 30 pregnant women. with a total sampling technique of 30 people. Place and time: at the Sally Clinic, Tembung on month April– July 2024. Results : Univariate : majority age 20-335 year as many as 18 people (60%) people, the majority of high school education as many as 15 people (50%), the majority of housewives as many as 28 people (88.8%), parity as many as 21 people (70%). Bivariate: Respondents suffering from pregnancy hypertension came from ages > 20 years and > 35 years. The chi square statistical test is p value = 0.000. The Relationship of Nutrition with Pregnancy Hypertension of 8 people (27%) pregnant women with pregnancy hypertension, the majority with malnutrition as many as 6 people (20%), the chi square statistical test is p value = 0.018 then the P value of age and nutrition is the same < 0.05 indicates there is a relationship between age and nutrition with the incidence of hypertension. In terms of parity as many as 8 people (27%) with the majority of multiparous parity. The chi square statistical test is p value = 0.363 which This means that p>0.05 indicates that there is no relationship between the incidence of hypertension and the incidence of pregnancy hypertension. Conclusion: There is a relationship between age and nutrition in the incidence of hypertension and there is no relationship between parity and the incidence of pregnancy hypertension.

CONTINUITY OF CARE FOR MIDWIFERY FOR SECON-DEGREE LACERACY OF THE BRITH WAY IN NY. N THE FRISKAH NOVITA PRIMARY CLINIC MEDAN LABUHAN DISTRICT MEDAN CITY NORTH SUMATRA IN 2025

Thu, 14 Aug 2025 00:00:00 +0700

Perineal rupture is a perineal tear that occurs when a baby is born either spontaneously or with the use of tools or actions. Perineal tears generally occur in the midline and can be extensive if the fetal head is born too quickly. Perineal tears occur in almost all primiparas and are not uncommon in subsequent deliveries. Perineal factors are influenced by several factors, namely maternal factors, fetal factors and assisting factors.(Nainggolan.et.2020) Determining continuous midwifery care (Continuity Of Care) for Mrs. N with a second-degree birth canal at the Friskah Novita Pratam Clinic, Medan Labuhan District, North Sumatra in 2025. This research design uses a descriptive method, especially through a case study approach, conducting research by observing and caring for a 35-year-old woman during pregnancy, childbirth, and postpartum, as well as during family planning. (Nilan Sari et al. 2025) During Mrs. N's pregnancy. N, 24 years old, G1P0A0, with a gestational age of 28 weeks and 3 days based on HPHT April 11, 2024 days or 40 weeks from the first day of the last menstruation. Continuous care Contuinity Of Care used as a final assignment report for midwifery students is very helpful in understanding the process of pregnancy, childbirth, postpartum, newborns and family planning, especially for Mrs. N during the third trimester of pregnancy which began on October 27, 2024 until February 16, 2025 and the author conducted Contuinity Of Care guidance with the aim of successful Contuinity Of Care care.

CONTINUOUS OBSTETRIC CARE (CONTINUITY OF CARE) IN NY A WITH GRADE 1 BIRTH ROAD LACERATION AT THE PRATAMA NIRMALA CLINIC, MEDAN PERJUANGAN DISTRICT YEAR 2025

Thu, 14 Aug 2025 00:00:00 +0700

Background: Maternal and Child Health (MCH) is a priority health issue in Indonesia, with the Sustainable Development Goals (SDGs) aiming to reduce maternal mortality to 70 per 100,000 live births by 2030. A common complication contributing to maternal morbidity is perineal laceration, which affects a significant number of women during childbirth due to factors such as fetal weight and incorrect pushing techniques. Objective: This study aims to provide comprehensive Continuity of Care (CoC) for Mrs. A, a 34-year-old G3P2A1, managing a first-degree birth canal laceration at the Pratama Nirmala Clinic in 2025. Methods: This research utilizes a descriptive case study Design using Helen Varney’s seven-step approach and SOAP documentation. Results: Mrs. A gave birth to a baby weighing 3,410 grams and experienced a first-degree laceration involving the vaginal mucosa and perineal skin. Continuity of care was provided through pregnancy, labor, and four postpartum visits, during which the mother opted for the Lactational Amenorrhea Method (MAL) for contraception. Conclusion: The application of Continuity of Care ensures holistic monitoring of the mother’s recovery and the newborn’s health, effectively managing complications such as first-degree lacerations to prevent further infection and promote optimal healing.

DRIVING FACTORS INFLUENCING THE INCIDENT OF PROLONGED LABOR AT PERMATA MADINA HOSPITAL PANYABUNGAN DISTRICT MANDAILING NATAL REGENCY NORTH SUMATRA PROVINCE IN 2025

Thu, 14 Aug 2025 00:00:00 +0700

Persalinan berkepanjangan merupakan salah satu komplikasi obstetri yang dapat meningkatkan risiko morbiditas dan mortalitas ibu dan bayi. Kondisi ini disebabkan oleh berbagai faktor yang saling berinteraksi, termasuk faktor ibu, janin, dan proses persalinan. Di Indonesia, insiden persalinan berkepanjangan masih relatif tinggi, terutama di daerah dengan akses terbatas terhadap layanan kesehatan yang optimal. Rumah Sakit Permata Madina, yang terletak di Kecamatan Panyabungan, Kabupaten Mandailing Natal, Provinsi Sumatera Utara, merupakan salah satu fasilitas kesehatan rujukan yang menangani kasus obstetri berat, termasuk persalinan berkepanjangan. Penelitian ini bertujuan untuk mengidentifikasi faktor-faktor yang mempengaruhi insiden persalinan berkepanjangan di Rumah Sakit Permata Madina pada tahun 2024. Penelitian ini menggunakan metode kuantitatif dengan desain case-control. Sebanyak 68 responden berpartisipasi, terdiri dari 34 ibu yang mengalami persalinan berkepanjangan (kasus) dan 34 ibu dengan persalinan normal (kontrol), yang dipilih melalui purposive sampling. Data dianalisis menggunakan uji Chi-Square untuk menentukan hubungan antar variabel. Hasil penelitian menunjukkan hubungan yang signifikan antara berat janin, presentasi janin, dan paritas dengan insiden persalinan berkepanjangan. Ibu dengan berat janin lebih besar, presentasi janin abnormal, dan paritas lebih rendah cenderung mengalami persalinan yang berkepanjangan. Kesimpulannya, faktor ibu dan janin memainkan peran penting dalam terjadinya persalinan yang berkepanjangan. Upaya pencegahan harus fokus pada deteksi dini dan pemantauan ketat kondisi ibu dan janin selama kehamilan dan persalinan. Para profesional kesehatan, terutama bidan dan dokter, diharapkan meningkatkan edukasi bagi ibu hamil tentang pentingnya pemeriksaan antenatal rutin untuk mengurangi kejadian persalinan yang berkepanjangan dan komplikasinya.

SERVICE EXCELLENT PEDIATRIC NURSING CARE MANAGEMENT ON AN. A WITH ACUTE RESPIRATORY TRACT INFECTION (ARI) IN ROOM RB 4 RSUP H. ADAM MALIK CITY MEDAN NORTH SUMATRA YEAR 2025

Thu, 14 Aug 2025 00:00:00 +0700

Acute Respiratory Tract Infections (ARI) remain a leading cause of morbidity and mortality among children in Indonesia. These cases are often exacerbated by environmental factors such as air pollution, cigarette smoke exposure, poor ventilation, and low immunization coverage. This study aims to implement nursing care management for children with a service excellent approach in treating a pediatric ARI patient in the Rindu B4 ward of H. Adam Malik General Hospital, North Sumatra. The study employed a descriptive case study method on a 13-year-old patient (An.A) diagnosed with ARI. Data were collected through interviews, observation, and document analysis. Nursing care was administered through a comprehensive process, including assessment, diagnosis, planning, implementation, and evaluation. Results showed significant improvements in the patient's condition following interventions in airway management, hyperthermia control, and nutritional support. The service excellent model based on the PACER principles (Professionalism, Accountability, Collaboration, Empathy, and Reliability) proved effective in enhancing care outcomes and family satisfaction. This study recommends strengthening family education and interprofessional collaboration to reduce ARI incidence and improve the quality of pediatric nursing care in hospital settings.

CONTINUITYOFCAREINMIDWIFERYFORBREASTENGORGEMENTINMRS.AATMIDWIFEWANTI'SINDEPENDENTPRACTICE, BACHELOROFMIDWIFERY, MEDAN DELI SUBDISTRICT, MEDAN CITY

Thu, 08 Jan 2026 00:00:00 +0700

Swollen breasts are a common problem for breastfeeding mothers, often caused by residual breast milk that is not properly expressed. This can cause swelling and pain in the breasts, as well as shiny skin, which is often referred to as milk congestion (Gustirini, 2021). Milk stasis is caused by several factors, such as flat or inverted nipples, improper breastfeeding position, nipple blisters, and lack of breast care. This can have an impact on breastfeeding, one of which is hindering the success of exclusive breastfeeding. If milk stasis is not treated, it can lead to mastitis or abscesses (Putri & Aristina, 2023). One way to treat breast milk blockage is through breast care, specifically brast care. This aims to improve blood circulation and prevent blockages in the milk ducts, thereby facilitating milk flow. Stimulation during care can also increase prolactin and oxytocin hormones, which help the baby get breast milk. If breast milk blockage is not treated quickly, the mother may develop mastitis or even an abscess (Gustirini, 2021).

CONTINUITY OF CARE FOR MRS. A WITH PERINEAL RUPTURE DEGREE II AT PMB RIMENDA TARIGAN, MEDAN DENAI DISTRICT, NORTH SUMATRA PROVINCE, MEDAN CITY IN 2025

Wed, 07 Jan 2026 00:00:00 +0700

According to WHO (World Health Organization) data, AKI is still very high with an average number of 295,000 women dying during pregnancy and childbirth, in 2018 the ASIAN country with the most AKI is Laos with the highest number of AKI 197 per 100,000 and AKI which is 20 per 1000 live births while when compared to Indonesia in 2021 it reached 2,982 people with an AKI of 305 per 100,000 live births and in North Sumatra in 2021 the AKI reached 119 cases and AKB 299 cases. Continuity of Care (COC) is an effort to help monitor and identify possible complications that accompany the mother and baby from pregnancy to the use of contraceptives by the mother. Purpose: Providing obstetric care services on a Continuity of Care (COC) basis starting from pregnancy, childbirth, postpartum period, newborn care, and family planning. Method: The method used for comprehensive treatment for Mrs. A is descriptive research, which systematically describes the phenomenon based on the type used, i.e. case studies. Result: Checking the completeness of the placenta and the presence of a rupture of the second degree birth canal (from the vaginal mucosa, posterior commissura of the perineal skin to the perineal muscle) and the placenta was born complete with a length of the umbilical cord of 50 cm, the number of cotyledons 19, and a diameter of 20 cm. Conclusion: Helps understand the pregnancy process to family planning. In Mrs. A, when the third trimester of pregnancy begins in November 2024 to Mare 2025, the author conducts COC guidance with the aim of successful Continuity of Care treatment(WHO, 2023)(Yoki Foranci, 2023)(Lapau, 2021)(Naohiro Yonemoto, 2023)

EMERGENCY NURSING CARE MANAGEMENT WITH SERVICE EXCELLENCE FOR MRS. N WITH HEMORRHAGIC STROKE IN RA 1 ROOM, H. ADAM MALIK GENERAL HOSPITAL, MEDAN, YEAR 2025

Thu, 14 Aug 2025 00:00:00 +0700

ABSTRACT

Hemorrhagic stroke is a critical medical emergency with a high risk of mortality and disability. This scientific paper discusses the emergency nursing care management with a service excellence approach for a patient diagnosed with hemorrhagic stroke in RA 1 Room, RSUP H. Adam Malik Medan. The nursing process included assessment, diagnosis, planning, implementation, and evaluation, focusing on airway clearance, mobility, and prevention of complications such as pressure ulcers. The study highlights the importance of applying professional nursing standards and comprehensive documentation to improve patient outcomes and safety. The results showed that quality nursing interventions can support recovery and enhance the patient's quality of life

The Relationship Between Postpartum Mothers' Knowledge and Attitudes Regarding Perineal Wound Care at The Rimenda BR Tarigan Prenatal Care Center in Medan Denai, North Sumatra 2025

Thu, 14 Aug 2025 00:00:00 +0700

According to World Health Organization (WHO) data in 2020, approximately 2.9 million cases of perineal tears occurred among women during childbirth. In Indonesia, about 75% of women who undergo vaginal delivery experience perineal lacerations. In the same year, among a total of 1,951 spontaneous vaginal births, this study aimed to examine the relationship between postpartum mothers’ knowledge and attitudes toward perineal wound care at PMB Rimenda Tarigan, North Sumatra, in 2025. This research employed a quantitative approach with a cross-sectional study design. A total of 63 respondents were included as the sample, and bivariate analysis was conducted using the Chi-square test. The findings showed that most respondents were aged 20–35 years, accounting for 60 individuals (95.2%). The majority had a secondary level of education (senior high school/vocational school), totaling 52 respondents (82.5%), and most were unemployed, with 57 respondents (90.5%). Good knowledge was observed in 38 respondents (60.3%), while 38 respondents (60.3%) also demonstrated positive attitudes. Additionally, 50 respondents (79.4%) performed appropriate perineal wound care practices. Statistical analysis revealed significant relationships between knowledge (p-value = 0.015) and attitude (p-value = 0.000) with perineal wound care. The study concludes that there is a significant association between postpartum mothers’ knowledge and attitudes and the practice of perineal wound care at PMB Rimenda Tarigan, North Sumatra, in 2025

MANAGEMENT OF EMERGENCY NURSING CARE WITH EXCELLENT SERVICE FOR MS.H WITH SEVERE HEAD INJURY IN THE ICU OF H. ADAM MALIK HOSPITAL MEDAN CITY NORTH SUMATRA PROVINCE IN 2025

Thu, 14 Aug 2025 00:00:00 +0700

Head injury is one of the most common emergency cases encountered in Emergency Departments (ED) and can lead to increased intracranial pressure and decreased consciousness. Prompt and appropriate nursing management, especially with a service-excellent approach, is essential to support patient recovery and prevent complications. Objective This scientific paper aims to describe the emergency nursing care management with a service excellence approach for Mrs. H, a patient with severe head injury treated in the Adult ICU of RSUP H. Adam Malik Medan. Method This is a descriptive case study involving one patient with severe head injury. Data collection was conducted through observation, interviews, and medical record reviews between April 25th and April 27th, 2025. The case focused on comprehensive nursing care processes including assessment, diagnosis, intervention, implementation, and evaluation. Results The main nursing diagnoses found were: ineffective spontaneous ventilation, risk of ineffective cerebral perfusion, and impaired physical mobility. Nursing interventions included respiratory monitoring, maintaining airway patency, positioning, collaboration for medical therapy, and continuous evaluation. Over three days of care, the patient's condition showed partial improvement but required ongoing intensive treatment. Conclusion The implementation of emergency nursing care with a service excellent approach in patients with severe head injury demands competent clinical skills, multidisciplinary collaboration, and continuous evaluation. Nurses play a vital role in managing clinical deterioration, ensuring airway support, monitoring neurological status, and supporting family education to optimize patient outcomes.

PHYSIOLOGICAL PREGNANCY CARE MENAGEMENT at THE SEHATI HUSADA CLINIC IN 2025

Thu, 14 Aug 2025 00:00:00 +0700

Labor is a natural process that every pregnant mother goes through to deliver her baby. During this process, there is stretching and widening of the mouth of the uterus due to contractions of the uterine muscles that push the baby out. Most mothers who undergo labor will feel uncomfortable due to the pain that arises during the process. Excessive pain can affect the smoothness of labor. This pain is generally caused by uterine contractions, cervical dilation, and psychological factors such as anxiety and fear of facing labor. Deep breath relaxation technique is a method that involves regulating the breath by inhaling air slowly, holding it for a moment, then exhaling slowly. This technique aims to help the body and mind become more relaxed. Deep breathing exercises not only serve to clear the mother's lungs, but also support the return of venous blood to the heart, thereby improving circulation so that the pain felt becomes more reduced. Maternal mortality rate (MMR) is one of the main indicators in assessing the success of the health sector. Maternal deaths can be categorized by cause into direct and indirect deaths. Direct maternal deaths occur due to complications that arise during pregnancy, childbirth, or the postpartum period, as well as due to non-optimal handling of these complications. In an effort to improve the degree of public health, one of the targeted indicators is the reduction of maternal mortality, from 359 per 100,000 live births based on 2012 IDHS data, to 306 per 100,000 live births in 2019 (Ministry of Health, 2019). In accordance with the Permenkes RI in the SDGs program, the national health system targets 2030. The existence of a mother has an important role in creating a prosperous family, so the loss of a mother can be a heavy blow to the family. The impact of this event is not only felt emotionally, but also affects social and economic aspects, both for families, communities, and the world of work.

CONTINUITY OF CARE FOR BREECH PREGNANCY IN MRS. D AT PRATAMA NIAR CLINIC, MEDAN AMPLAS DISTRICT, MEDAN CITY IN 2025

Thu, 14 Aug 2025 00:00:00 +0700

Position fetus with location breech (buttocks) is in the part bottom stomach mother (pelvic area) Position fetus breech in pregnancy can worsening the prognosis of labor Because risky tall cause various complications, both in the mother and baby. possible complications happen among other difficulties moment the exit head last (after coming head), risk lack oxygen (asphyxia), injury brain (intracranial trauma), fracture bone or dislocation, as well as paralysis nerve brachialis. While that, mother pregnant can experience complications like bleeding, road injuries born, and improvement risk infection. Use of position knee chest and prenatal yoga exercises help change position fetus breech, namely with do chest- knee position classified as simple and can done independent at home. The method used is report case with SOAP documentation. With method interviews and examinations physical, subject in study This is Mrs. D, 27 years old, G2P1A0 age 30 weeks 3 days pregnant with pregnancy location breech. In the implementation knee chest position against rotation head fetus Mother third trimester pregnant with location breech so that get optimal results.

THE RELATIONSHIP BETWEEN PREECLAMPSIA RISK FACTORS AND THE INCIDENCE OF LOW BIRTH WEIGHT (LBW) BABIES AT ARUN LHOKSEUMAWE HOSPITAL, LHOKSEUMAWE CITY

Thu, 14 Aug 2025 00:00:00 +0700

This study aims to determine the relationship between preeclampsia risk factors and the incidence of low birth weight (LBW) babies at Arun Lhokseumawe Hospital, Lhokseumawe City, Aceh Province in 2024, with the background that LBW is still a major public health problem in Indonesia and the world, which contributes greatly to infant morbidity, mortality, and disability, and is one of the important indicators in the Sustainable Development Goals (SDGs) and the National Medium-Term Development Plan (RPJMN). Based on data from WHO and the Indonesian Ministry of Health, LBW is the main cause of neonatal death in Indonesia, with the proportion of infant deaths due to LBW reaching 32.2% in 2020. Preeclampsia, which is a pregnancy disorder characterized by hypertension, edema, and proteinuria, is one of the main causes of LBW because it can inhibit fetal growth due to impaired blood flow and nutrition to the placenta. This study uses a quantitative approach with a cross-sectional design, with a population of all mothers giving birth at Arun Lhokseumawe General Hospital in the period January-April 2024, and samples were taken based on medical record data, where 10 cases of LBW were found, 5 of which had a history of preeclampsia. The variables analyzed included maternal age, parity, and anemia as risk factors for preeclampsia, and their relationship with the incidence of LBW. The results of this study are expected to provide theoretical contributions as a reference for the development of obstetrics, scientific benefits for further research, and practical benefits for hospitals in improving the quality of services, especially the prevention and treatment of preeclampsia to reduce the incidence of LBW. Initial findings and literature reviews indicate a significant relationship between preeclampsia and the incidence of LBW, in line with previous studies stating that pregnant women with preeclampsia have a higher risk of giving birth to babies with low birth weight, so that early detection efforts, education, and appropriate interventions are needed to reduce this risk and improve the health of mothers and babies in the future.

MANAGEMENT OF MEDICAL-SURGICAL NURSING CARE WITH SERVICE EXCELLENCE FOR MR. S WITH OPEN TIBIAL FRACTURE POST-ORIF IN ROOM RB 3 AT H. A DAM MALIK GENERAL HOSPITAL MEDAN CITY

Thu, 14 Aug 2025 00:00:00 +0700

Fractures are a condition characterized by the discontinuity of bone structure, which causes damage to the surrounding tissues. The chances of recovery are significantly higher when first aid is administered before the patient is taken to the hospital. There are various types of fractures, such as longitudinal, transverse, or mid-shaft fractures. These injuries are commonly accompanied by automatic tissue damage at the time the fracture occurs. According to a 2018 report by the World Health Organization (WHO), the prevalence of fractures reached 4.9%, with approximately 25 million cases recorded. In the previous year, 2017, there were 20 million cases with a prevalence rate of 4.2%. The number increased to 21 million cases in 2018 due to traffic accidents, although the prevalence slightly decreased to 3.8%. The latest data in 2022 showed a significant increase, with cases reaching up to 440 million worldwide. This study aims to provide an overview of medical-surgical nursing care for patients with fractures. The method used is a descriptive method, which aims to illustrate the ongoing phenomenon. The study includes a literature review with a nursing process approach consisting of assessment, diagnosis, planning, implementation, and evaluation. Based on the study results, the author provided medical-surgical nursing care to Mr. S, a patient who suffered an open tibial fracture following an ORIF (Open Reduction and Internal Fixation) procedure, for three days in Ward 3 at H. Adam Malik General Hospital. The results showed that the patient was able to use non-pharmacological techniques, such as deep breathing relaxation, to relieve postoperative pain. In addition, the issue of impaired physical mobility showed improvement through early mobilization carried out in stages.

EXCELLENT PSYCHIATRIC NURSING CARE MANAGEMENT FOR Mr. S WITH SOCIAL ISOLATION AT PROF. DR. MUHAMMAD ILDREM MENTAL HOSPITAL NORTH SUMATRA IN 2025

Thu, 14 Aug 2025 00:00:00 +0700

Social isolation is a common problem in individuals with mental disorders, especially schizophrenia, which significantly affects social function and quality of life. This case study aims to explore the implementation of excellent nursing care in managing a patient with schizophrenia who exhibits symptoms of social withdrawal. The study was conducted at Prof. Dr. Muhammad Ildrem Mental Hospital in North Sumatra in March 2025. A qualitative descriptive method with a nursing care approach was used, consisting of five steps: assessment, nursing diagnosis, intervention, implementation, and evaluation. The subject was a 62 year old male with repeated relapses, diagnosed with paranoid schizophrenia and showing signs of social isolation such as withdrawal, low self-esteem, and lack of communication. Interventions were carried out using therapeutic communication and a structured strategy (SP1-SP4) focused on building trust, exploring the causes of social isolation, and practicing social interaction. The evaluation showed significant improvement, where the patient became more responsive, engaged in conversation, and developed the confidence to interact with peers. This study highlights the importance of structured nursing care in enhancing social functioning in psychiatric patients and supports the role of nurses as care providers and educators.

FACTORS RELATING TO PUBLIC MOTHER'S VISITS IN THE WORKING AREA OF THE PUSKESMAS IN THE VILLAGE OF HAMPARAN PERAK PERAK

Thu, 14 Aug 2025 00:00:00 +0700

One of the successes of the postpartum period is to prevent maternal mortality during the postpartum period. Health services for postpartum mothers are needed because the 2 month period after giving birth to the mother's physical condition has not fully recovered, so she is vulnerable to various related infectious diseases and can pose a risk of maternal death. WHO estimates that around 10.7 million women worldwide die from childbirth and 25-50% of the causes are health problems, childbirth and childbirth. This study aims to determine the relationship between age, occupation, education, pregnancy distance, and parity on postpartum visits in the Samata Gowa Health Center work area in 2019-2020. This type of research is an analytical study with a cross-sectional study design. The population of this study were all postpartum mothers who were recorded visiting the Samata Gowa Public Health Center register book in the time span starting from January 2019 to October 2020, namely 489 people. The sampling technique used was simple random sampling with a total sample of 141 postpartum mothers. Data analysis used univariate and bivariate analysis. The results showed that as many as 41.8% of respondents who were incomplete made postnatal visits and 58.2% who were complete made postnatal visits. There is no relationship between age and value (p = 0.602), work with value (p = 1,000), education with value (p = 0.955), pregnancy distance with value (p = 0.353) and there is a relationship between parity (p = 0.038) with postpartum visits at Samata Gowa Health Center. Conclusion: In this study, it can be seen that there is a relationship between parity and postpartum visits. Meanwhile, age, occupation, education and pregnancy distance showed that there was no relationship with postpartum visits. This study suggests increasing awareness and emphasizing counseling for postpartum mothers who think that they will not be at risk / low risk during the postpartum period and it is hoped that mothers can limit parity in order to maximize the implementation of routine postpartum visits to anticipate complications during childbirth Bibliography : 42 (2010-2020)

SUSTAINABLE MIDWIFERY CARE ( Continuity Of Care ) FOR BABY MRS. Y WITH UMBILICAL CORD INFECTION AT PRATAMA FRISKAH NOVITA CLINIC, MEDAN LABUHAN DISTRICT, MEDAN CITY IN 2025

Thu, 14 Aug 2025 00:00:00 +0700

Umbilical Cord Infection is an infection that occurs in the form of swelling, at the end of the umbilical cord will come out pus, around the base of the umbilical cord will be red and accompanied by edema, in severe infection conditions. Objective: To provide obstetric services with continuity of care and treatment of umbilical cord infections at the Friskah Novita Primary Clinic, Medan Labuhan District, Medan City in 2025”. Method: used in collecting data that is directly related to patients who will be studied in more depth. This data collection is through questionnaires, forms, observations, and others related to data collection. Data collection can also be done through interviews or interviews from direct patients (Auto anamnesis) and data from families (Allow anamnesis). According to the World Health Organization (WHO), 1.3 million babies will die from umbilical cord infections worldwide in 2021. According to UNICEF, in 2022, around 2.6 million babies worldwide will die each year in 2021. In some countries, the death rate from infections is higher than in other countries

NURSING CARE MANAGEMENT WITH EXCELLENT SERVICE FOR MRS. R.D. WITH GOUT ARTHRITIS AT THE BINJAI ELDERLY SOCIAL SERVICES UNIT, SOCIAL AFFAIRS OFFICE OF NORTH SUMATRA PROVINCE IN 2025

Thu, 14 Aug 2025 00:00:00 +0700

Based on data from the World Health Organization (WHO) in 2019, the number of gout arthritis cases increased significantly, reaching 1,370 (or approximately 33.3) by 2023. The country with the highest recorded number of cases is the United States, where about 26.3% of the total population has been affected. In Indonesia, the majority of gout arthritis sufferers are men, with the most affected age group being those aged over 45 years (Syamsidar, 2023). According to the Kamus Besar Bahasa Indonesia (KBBI), gout (commonly called gaut) is a metabolic disease characterized by elevated levels of uric acid in the blood serum and the formation of sodium urate deposits in various body tissues, including joints and soft tissues. This condition is usually caused by impaired renal excretion of uric acid or excessive endogenous production. Without proper and effective treatment, gout can progress to more serious stages, such as chronic gout, tophus formation (hard deposits around joints), and even severe kidney dysfunction. These complications can significantly impact a patient’s quality of life, impair mobility, and cause persistent pain. The prevalence of gout arthritis in Indonesia has not been extensively studied, but data indicate that the prevalence of hyperuricemia (elevated levels of uric acid in the blood) in Indonesia ranges from 18.6% to 47.6%. Hyperuricemia is a major risk factor that can contribute to the development of gout, although not all individuals with high uric acid levels will develop the disease. This high prevalence suggests that gout and related uric acid disorders may be a significant public health concern in Indonesia, especially given the increasing number of cases related to lifestyle, dietary habits, and genetic factors (Safira & Tengah, 2022). in North Sumatra Province, the prevalence of arthritis diagnosed by healthcare professionals reached 8.4%, while based on diagnosis or self-reported symptoms, the figure increased to 19.2%. Meanwhile, in Medan City, the prevalence based on professional diagnosis was 5.1%, and when considering both diagnosis and symptoms, it rose to 17.2% (Hasibuan & Simamora, 2020)

EFFECTIVENESS OF BREAST CARE EDUCATION WITH BROCHURE MEDIA TO INCREASE KNOWLEDGE ABOUT BREAST DAMS IN POST PARTUM MOTHERS AT DAMAIYANTI CLINIC, SUB-DISTRICT MEDAN DENAI NORTH SUMATRA PROVINCE IN 2024

Thu, 14 Aug 2025 00:00:00 +0700

ABSTRACT

Breast dam is one of the breastfeeding disorders that is often experienced by postpartum mothers and is at risk of causing serious complications such as mastitis and breast abscess if not treated immediately. The purpose of this study is to evaluate how effective the provision of education about breastcare through brochure media is in increasing the knowledge of postpartum mothers about breast dams. This study uses a quantitative approach with a quasi-experimental design involving two groups, namely the group given the intervention and the control group, with pre-test and post-test methods. The number of samples was 30 postpartum mothers who were selected using the total sampling technique, 15 people each in the treatment and control group. The instruments used were questionnaires that were distributed before and after education, then analyzed using the Paired Sample T-Test statistical test. The results showed that before being educated, most respondents had a low level of knowledge (80%). However, after getting education through brochures, there was an increase in knowledge with 27% of respondents reaching a good level of knowledge, 37% adequate, and 37% still lacking. Statistical tests showed significant results (p = 0.000 < 0.05), which indicated a significant difference between before and after education. Thus, it can be concluded that breastcare education delivered using brochure media has proven to be effective in increasing postpartum mothers' understanding of breast dams. The results of this study are expected to be reference materials in health counseling to support the success of

ENTAL HEALTH NURSING CARE MANAGEMENT FOR MR. M WITH LOW SELF-ESTEEM AT PROF. DR. MUHAMMAD ILDREM MENTAL HOSPITAL, MEDAN, NORTH SUMATRA PROVINCE

Thu, 14 Aug 2025 00:00:00 +0700

Background: Schizophrenia is a severe mental disorder that impairs brain functions, including cognition, emotion, and behavior. It is categorized by positive symptoms (delusions and hallucinations), negative symptoms (social withdrawal and flattened affect), and cognitive deficits (impaired memory and concentration). Although it affects approximately 24 million people worldwide (0.32% of the population), the National Institute of Mental Health (NIMH) ranks it among the top 15 leading causes of disability globally. In Indonesia, the 2023 Indonesian Health Survey highlights significant regional variation: the Special Region of Yogyakarta (DIY) has a prevalence of 9.3%, whereas North Sumatra ranks 21st nationwide at 6.3%.
Problem: Initial 2024 data at Prof. Dr. Muhammad Ildrem Mental Hospital indicated that 5% of patients presenting with low self-esteem were diagnosed with schizophrenia-related conditions. This underscores a significant correlation between negative self-perception and the exacerbation of severe psychotic disorders.
Objective: The primary aim of this study is to implement comprehensive mental health nursing care management for Mr. M, a patient suffering from low self-esteem, at Prof. Dr. Muhammad Ildrem Mental Hospital in Medan, North Sumatra, in 2025.

FACTORS INFLUENCING ANXIETY IN EARLY MOBILIZATION OF MOTHERS AFTER CAESAREAN DELIVERY AT PERMATA HOSPITAL, MEDINA, MANDAILING NATAL REGENCY, NORTH SUMATERA PROVINCE

Thu, 14 Aug 2025 00:00:00 +0700

The trend of childbirth with SC has led to an increase in sectio caesarea procedures in a number of hospitals, both in private hospitals and government hospitals. About 18.5 million caesarean section births are performed each year worldwide. Postoperative patients of sectio caesarea usually feel various discomforts, one of which is pain. This study aims to find out the factors that affect anxiety in carrying out early mobilization in postpartum mothers after cesarean section at Permata Madina Hospital in 2024. Quantitative research with cross-sectional design. The technique of taking samepl with purposive sides, a sample of 52 people. Data analysis with chi square. almost 29 of the mothers who received family support were able to have mild anxiety to mobilize, almost 29 people (87%), almost all of the post-SC mothers with a mild labor pain scale had mild anxiety to mobilize as many as 29 people (87%), most of the primipara mothers had severe anxiety to mobilize as many as 24 people (46.1%). The results of the chi square test, p value = 0.02, were found to be related between family support, post SC pain with parity with the independence of the mother to do early mobilization. It is hoped that it can be improved in accompanying and observing the mother post-cesarean section surgery in carrying out early mobilization as well as the level of anxiety and pain felt by the mother.

The Relationship Between Maternal Anxiety and Early Management of Febrile Seizures in Children at RSUP Haji Adam Malik Medan

Thu, 08 Jan 2026 00:00:00 +0700

Background: Febrile seizures (FS) remain a significant source of parental distress, particularly among mothers who act as primary caregivers. This study investigates the correlation between maternal anxiety levels and the efficacy of early management of febrile seizures at RSUP Haji Adam Malik Medan. Using a descriptive-analytic design with a cross-sectional approach, data were gathered from motherswhose children were treated at the pediatric department. Anxiety was assessed using the Hamilton Anxiety Rating Scale (HARS), while management skills were evaluated through detailed narrative interviews. The results indicate a significant inverse relationship (p < 0.05): higher maternal anxiety levels consistently correlate with poor first-aid responses. Mothers experiencing severe anxiety often succumb to "cognitive freezing" or perform contraindicated actions such as oral insertion of objects. These findings emphasize the urgent need for hospitals to implement family-centered education that combines medical instructions with psychological coping strategies. Conclusion: There is a significant relationship between maternal anxiety levels and the ability to manage febrile seizures in children. Continuous education for mothers is necessary to reduce anxiety and improve seizure management skills.

CONTINUITY OF CARE FOR MRS. E WITH SHOULDER DYSTOCIA AT THE MOTHER NIETA CLINIC, HAMPARAN PERAK DISTRICT, DELI SERDANG REGENCY, NORTH OF SUMATERA 2025

Thu, 14 Aug 2025 00:00:00 +0700

Improving maternal and child health, reproductive health is a national strategy for health Development. Development targets for 2030 include improving public health to increase life expectancy, reduce maternal and child mortality, and improve nutrition for toddlers. Mortality rate, maternal mortality (MMR) worldwide, according to the World Health Organization ( WHO), in 2021, there were 395,000 deaths per 100,000 live births (WHO, 2021). ASEAN reports a maternal mortality rate of 253 per 100,000 live births (ASEAN Secretariat, 2021). Indonesia's maternal mortality rate in the same year was as many as 7,389 cases, different from the year previously, which experienced 4,627 cases of maternal deaths ( Ministry of Health of the Republic of Indonesia, 2021). The target in the Ministry of Health's Strategic Plan to reduce the AKB is to lower the IMR from 18.6 per 1,000 live births in 2022 to 17.6 in 2023 and to 16 in 2024. Annual IMR data is not available. Available, so that the 2023 achievements can be used with the 2022 achievement data. Shoulder dystocia is a complication that occurs during childbirth when the fetal shoulder gets stuck in the birth canal after the fetus's head is delivered. Shoulder dystocia mainly caused by deformity pelvis, failure of the shoulders to “fold” into in pelvis ( eg: in macrosomia ) caused by the phase active and short second stage of labor in multiparas so that decline too big head fast causes the shoulder to not fold at the time through road born or head has through door middle pelvis after experience successful prolongation of the second stage of labor on the shoulder fold enter to in pelvis.

MEDICAL-SURGICAL NURSING CARE MANAGEMENT WITH A SERVICE EXCELLENCE APPROACH FOR MR. H WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) AT RSUP H. ADAM MALIK, MEDAN CITY, NORTH SUMATRA, IN 2025

Thu, 14 Aug 2025 00:00:00 +0700

Chronic Obstructive Pulmonary Disease (COPD) is a progressive respiratory disorder characterized by airflow limitation due to chronic inflammatory responses to inhaled particles or gases. COPD ranks among the leading causes of death worldwide and has a high prevalence, including in North Sumatra Province. This study aims to describe the management of medical-surgical nursing care based on service excellence principles for a COPD patient, specifically Mr. H, who was treated in Room RA6 of RSUP H. Adam Malik Medan. The research method employed is descriptive, using a case study approach. Nursing care was carried out systematically through the stages of assessment, nursing diagnosis, planning, implementation, and evaluation. Interventions focused on managing ineffective breathing patterns, airway clearance, activity intolerance, and anxiety, with the application of service excellence values, including empathy, effective communication, and patient and family education. The results showed that comprehensive and collaborative nursing care improved the patient's clinical condition and accelerated recovery. This study recommends enhancing family education and strengthening nurses' competencies in the professional and ethical management of patients with COPD.

MANAGEMENT OF SERVICE EXCELLENT HEALTH CARE MANAGEMENT TO Mr. S, WITH SOCIAL ISOLATION WITHDRAWAL IN THE GUNUNG SITOLI ROOM Prof. Dr. MUHAMMAD ILDREM PSYCHIATRIC HOSPITAL NORTH SUMATERA PROVINCE YEAR 2025

Thu, 14 Aug 2025 00:00:00 +0700

Mental disorders, including social isolation and withdrawal, are conditions that affect a person's behavior and social interactions (Mubin Fatkhul et al., 2024). This case study was conducted in Gunung Sitoli Room, Prof. Dr. Muhammad Ildrem Psychiatric Hospital, on Mr. S, 65 years old, with a history of schizophrenia and relapse due to social isolation. S, 65 years old, with a history of schizophrenia and relapse due to non-compliance with medication. The purpose of this activity is to apply nursing care using the Implementation Strategy (IS) approach to address social isolation and withdrawal. Interventions focused on improving social interaction skills, self-care, and self-esteem. The results of the 4-day implementation indicated that Mr. S interacted more effectively, improved his hygiene, and increased his self-esteem. S was able to interact better, improve personal hygiene, and began to recognize and carry out his positive potential. In conclusion, the SP approach has proven effective in reducing symptoms of social isolation, improving self-care, and building self-esteem in patients with mental disorders. It can be a helpful intervention model in mental health nursing practice.

EDUCATION ON HANDLING AND PREVENTION OF ANEMIA IN PREGNANT WOMEN THROUGH ANTE NATAL CARE EXAMINATIONS AND PROVISION OF BLOOD-ENHANCING TABLETS AT THE PADANG BULAN PUBLIC HEALTH CENTER

Thu, 14 Aug 2025 00:00:00 +0700

Anemia in pregnant women is a health problem that can impact the safety of both mother and fetus. This study aims to analyze the effectiveness of antenatal care (ANC) and iron supplementation (ITP) in reducing the incidence of anemia in the Padang Bulan Community Health Center (Puskesmas) work area. The method used was a descriptive study using a survey approach and direct observation of pregnant women attending ANC. The results showed a decrease in the number of pregnant women experiencing anemia after receiving counseling, antenatal checkups, and regular iron supplementation. Education integrated with primary health care services has proven effective in increasing pregnant women's knowledge about the importance of consuming iron supplements and monitoring their hemoglobin status. In conclusion, regular ANC and regular iron supplementation play a significant role in reducing anemia in pregnant women.

CONTINUITY OF CARE IN MRS. R WITH MILD ANEMIA AT SARFINA INPATIENT PRIMARY CLINIC, MEDAN POLONIA DISTRICT MEDAN CITY, NORTH SUMATRA PROVINCE IN 2025

Wed, 07 Jan 2026 00:00:00 +0700

Anemia during pregnancy, particularly in the third trimester, remains a significant contributor to maternal and infant mortality due to the risk of postpartum hemorrhage and low birth weight. In Indonesia, despite a decline in prevalence, integrated monitoring remains crucial to ensure hemoglobin stability before delivery. This study aimed to evaluate the effectiveness of the Continuity of Care (CoC) model in managing mild anemia in a pregnant woman through combined pharmacological and nutritional interventions.This research employed a longitudinal case study approach following a 30-year-old multigravida (G4P3A0) patient, Mrs. R, at the Sarfina Inpatient Primary Clinic, Medan. The midwifery care was conducted over three antenatal visits in the third trimester, adhering to the national standard of at least six ANC visits. Interventions included the administration of 90 iron (Fe) tablets, intensive health education (KIE), and the incorporation of natural iron boosters, specifically dragon fruit and beetroot juice. At the second visit, the patient presented with symptoms of dizziness and fatigue, with a laboratory-confirmed hemoglobin (Hb) level of 8.9 g/dL, indicating mild anemia. Following the implementation of the CoC model and nutritional therapy, the patient showed significant clinical improvement. By the third visit, the hemoglobin level increased to 12.8 g/dL, reaching a normal range. Furthermore, physiological discomforts such as frequent urination and sleep disturbances were successfully managed through fluid regulation and hygiene education. The Continuity of Care (CoC) model is highly effective in stabilizing hemoglobin levels and preventing pregnancy complications. The synergy between iron supplementation and superfood-based nutrition (beetroot and dragon fruit) provides a robust framework for improving maternal health outcomes. This study suggests that healthcare providers should integrate holistic nutritional counseling into standard antenatal care to optimize maternal well-being

GERONTIC NURSING CARE MANAGEMENT EXCELLENT SERVICE ON NY. S WITH URINARY INCONTINENCE IN UPTD SOCIAL SERVICES ELDERLY BINJAI PROVINCIAL SOCIAL SERVICE NORTH SUMATRA IN 2025

Thu, 08 Jan 2026 00:00:00 +0700

ABSTRACT

The Decree of the Minister of National Development Planning Number Kep.136/M.PPN/HK/12/2021 is a strategic step in supporting the achievement of the Sustainable Development Goals (SDGs), particularly Goal 3 (health and well-being) and Goal 17 (partnerships to achieve the goals). One relevant area is geriatric nursing, particularly in the management of non-communicable diseases such as urinary incontinence in the elderly. This study aims to evaluate service-excellent geriatric nursing care management in the case of Mrs. S, an elderly resident of the UPTD for Elderly Social Services in Binjai, North Sumatra, who experienced urinary incontinence. The assessment method was carried out through interviews, observation, and documentation of nursing care. The results showed that Mrs. S had experienced urinary incontinence for the past two years, accompanied by sleep disturbances and decreased bladder control. The main interventions provided were health education and Kegel exercises twice daily. These exercises have been proven effective in improving urinary control and the physical and emotional comfort of the elderly. The intervention was implemented collaboratively between nurses, families, and institutions. This study emphasizes the importance of a multidisciplinary approach, psychological support, and integrated care that refers to the SDGs principles to improve the quality of life of the elderly in social institutions

THE RELATIONSHIP BETWEEN PREGNANT WOMEN'S KNOWLEDGE AND ATTITUDES ABOUT PERINEUM MASSAGE IN REDUCING PERINEUM RUPTURE AT THE MANIS MATA COMMUNITY HEALTH CENTER MANIS MATA DISTRICT KETAPANG REGENCY WEST KALIMANTAN PROVINCE IN 2024

Thu, 14 Aug 2025 00:00:00 +0700

Perineal rupture is a complication of childbirth that can increase the risk of bleeding and infection in the mother. One preventative measure that can be performed during pregnancy is perineal massage, which is influenced by the level of knowledge and attitudes of pregnant women. This study aims to determine the relationship between knowledge and attitudes of pregnant women regarding perineal massage and reducing perineal rupture at the Manis Mata Community Health Center (UPTD), Manis Mata District, Ketapang Regency, West Kalimantan Province in 2024. This study used a quantitative design with a cross-sectional approach. The sample population was all 45 pregnant women visiting the Manis Mata Community Health Center (UPTD), using a total sampling technique. Data were collected using a knowledge and attitude questionnaire and a perineal massage observation sheet. Data were analyzed univariately and bivariately using the Chi-Square test with a 95% confidence level (α = 0.05). The results showed that the majority of respondents had high knowledge (54%) and positive attitudes (55%) toward perineal massage. Fifty-three percent of respondents performed perineal massage regularly. The bivariate test results showed a significant relationship between pregnant women's knowledge and perineal massage practice (p-value = 0.000) and a significant relationship between pregnant women's attitudes and perineal massage practice (p-value = 0.032). The conclusion of this study indicates that pregnant women's knowledge and attitudes are significantly related to the practice of perineal massage as an effort to reduce the risk of perineal rupture.

ANALYSIS OF ADOLESCENT GIRLS' RESPONSES REGARDING SECONDARY SEXUAL DEVELOPMENT DURING PUBERTY AT SMP NEGERI 1 BISKANG DANAU PARIS DISTRICT, ACEH SINGKIL DISTRICT, ACEH PROVINCE, 2024

Thu, 14 Aug 2025 00:00:00 +0700

Puberty is an important transition period in a teenager's life, marked by physical, hormonal and psychological changes, including secondary sexual development. This study aims to analyze the level of knowledge of young women regarding secondary sexual development during puberty. This research method uses a quantitative descriptive design with a total sampling technique of 30 female students at SMP Negeri 1 Biskang. Data was collected using a questionnaire and analyzed using a Likert scale. The results showed that the majority of respondents (63.4%) had high knowledge about puberty, but only 43.4% had high knowledge about reproductive organs. The highest knowledge was found in the 14–15 year age group and respondents who were raised by their parents. The most dominant sources of information come from parents and schools. The conclusion from this research is that there is still a need for ongoing education regarding secondary sexual development, especially from parents and educational institutions.

CONTINUITY OF CARE FOR MRS. S WITH MILD ANEMIA AT THE BPM MISBAH CLINIC, MEDAN CITY, NORTH SUMATRA PROVINCE, 2025

Thu, 14 Aug 2025 00:00:00 +0700

Anemia is a condition in which HB levels are below normal, in Indonesia anemia is generally caused by iron deficiency so it is better known as iron nutritional anemia which is one of the most common disorders during pregnancy pregnant women generally experience iron depletion so they provide little to the fetus needed for normal iron metabolism, Then it will become anemia when the mother's hemoglobin level drops below 11g / dl during the third trimester. Purpose: of this study is to increase the understanding of pregnant women about the risks of pregnancy and complications that can occur before pregnancy and during pregnancy. Method: used in midwifery care for Mrs. S with Mild Anemia using the Design in this study is a case study described descriptively, namely a case study or case study. from the results of data collection obtained from several methods used for primary data, namely by using observation data, interviews (anamnesis), and the results of direct obstetric physical measurements. Secondary data with, examination, KIA book as a client development record book. Results: From this study shows an increase in emergency treatment for mothers with Mild Anemia. It is hoped that comprehensive midwifery care can improve patient knowledge. Conclusion: Midwifery care in New York City was conducted in accordance with the theory and documented in Helen Varney's 7-step plan for mild anemia

THE RELATIONSHIP BETWEEN PREGNANT WOMEN'S KNOWLEDGE AND COMPLIANCE WITH FE TABLET CONSUMPTION IN PMB NURBAITI, NORTH ACEH DISTRICT ACEH PROVINCE IN 2024

Thu, 14 Aug 2025 00:00:00 +0700

Background: The World Health Organization (WHO) states that approximately 40% of maternal mortality rates (MMR) are caused by iron deficiency anemia, which leads to bleeding. Data from the 2022 Aceh Provincial Health Profile indicate that the proportion of pregnant women receiving iron tablets (90 tablets) is 92.70% in Lhokseumawe City, with the lowest coverage of 49.03% in Simeulue Regency; the provincial average is 73.20%. The low coverage of iron tablets in Aceh Province is attributable to an overestimation of the target population of pregnant women based on actual field data. Another possible cause is the taste of the iron tablets, which can cause nausea and vomiting (Aceh Health Profile, 2022). Objective: To determine the relationship between pregnant women's knowledge and adherence to iron tablet consumption at the Nurbaiti PMB in North Aceh Regency in 2024. Method: This study used a cross-sectional approach. Data analysis employed the chi-square test. This study was conducted at the Siti Fujana BPM in East Aceh Regency. The population comprised 30 individuals; the sampling technique was total sampling. Results: The majority of respondents had insufficient knowledge and did not exclusively breastfeed (20 respondents (52.6%), while the majority of respondents had good knowledge and solely breastfed (10 respondents (26.3%). Conclusion: The majority of pregnant women had good knowledge (13 respondents (43.3%), and 17 respondents (56.7%) had poor knowledge. The majority of pregnant women did not experience anemia (13 respondents (43.3%), and 18 respondents (60.0%) experienced anemia. There was a significant association between maternal knowledge, adherence to iron tablet use, and anemia incidence (p=0.013).

MATERNITY NURSING CARE MANAGEMENT WITH EXCELLENT SERVICE FOR MRS.A WITH SECOND-TRIMESTER HYPERTENSION AT PERA CLINIC, MEDAN TUNTUNGAN DISTRICT NORTH SUMATRA PROVINCE, IN 2025

Thu, 14 Aug 2025 00:00:00 +0700

Background: Hypertension during pregnancy remains a major obstetric complication, contributing significantly to maternal and fetal morbidity and mortality. In the primary care setting, standardized yet empathetic care is essential for early detection and prevention. Objective: This case study aims to implement and analyze a maternity nursing care management model based on "Service Excellence" for Mrs. A, a pregnant woman diagnosed with hypertension during her second trimester. Methods: The study was conducted at Pera Clinic, Medan Tuntungan, North Sumatra, using a longitudinal nursing process approach. This included a comprehensive clinical assessment, nursing diagnosis formulation, evidence-based care planning, implementation, and systematic evaluation. The "Service Excellence" framework focused on professionalism, responsiveness, and empathetic communication. Results: The application of service-excellence nursing care resulted in improved clinical monitoring of blood pressure, enhanced patient health literacy, and high patient satisfaction. Furthermore, the collaborative approach helped in maintaining blood pressure stability and preventing progression toward preeclampsia. Conclusion: This study highlights that professional, collaborative, and responsive nursing services are vital in managing hypertensive disorders in pregnancy. Such a model directly supports the Sustainable Development Goals (SDGs) by contributing to the reduction of maternal mortality through high-quality, patient-centered care

CONTINUOUS MIDWIFERY CARE (CONTINUITY OF CARE) FOR MRS. A WITH SECOND-DEGREE LACERATION AT PMB DESY FAHRYANI, MEDAN BELAWAN DISTRICT, MEDAN CITY, NORTH SUMATRA PROVINCE IN 2025

Thu, 08 Jan 2026 00:00:00 +0700

Background: A birth canal laceration is a tear in the midline of the birth canal that can become extensive if the fetus's head is born too soon. Influencing factors include improper childbirth techniques, incorrect straining techniques, and fetal macrosomia (weight >4000g). Objective: This study aims to provide and analyze comprehensive midwifery care for Mrs. A, focusing on the prevention and management of perineal lacerations. Methods: The method used is a case study, conducted by examining a clinical problem across longitudinal cases. The case is analyzed in depth, examining both the case's specific aspects and responses to exposures. The care follows continuous obstetric care (CoC) from pregnancy, through the first stage of labor (kala 1), to birth and family planning, using the Varney midwifery management method and documented via SOAP notes. Results: The care provided included laceration wound treatment for Mrs. A, which was monitored closely alongside education sessions from pregnancy to birth control. Through proper perineal massage during pregnancy and controlled delivery techniques during the first stage of labor, the risk of extensive laceration was minimized. Conclusion: Continuous midwifery care is effective in identifying risk factors for birth canal lacerations and improving the mother's recovery through integrated monitoring and education.

THE IMPACT OF SIDE EFFECTS ON DISCONTINUATION OF LONG-TERM CONTRACEPTIVE METHODS (LTCM) AT BPM MELIA LISNA, SOUTHEAST ACEH, 2024

Thu, 08 Jan 2026 00:00:00 +0700

Uncontrolled population growth poses a serious challenge to national development, including in Indonesia. One of the government's efforts to control the population is through the Family Planning (FP) program, particularly by promoting the use of Long-Term Contraceptive Methods (LTCM). However, the high rate of discontinuation (dropout) in LTCM use, especially due to side effects, hinders the effectiveness of the program. This study aims to examine the relationship between side effects and the dropout incidence of LTCM use at BPM Melia Lisna, Gusung Batu Village, Deleng Pokhkisen Subdistrict, Southeast Aceh Regency, in 2024. This research employed a descriptive-analytic design with a quantitative cross-sectional approach. The sample consisted of 15 respondents—women who had previously used LTCM and visited BPM Melia Lisna—selected using total sampling. Data were collected using questionnaires and analyzed with the chi-square statistical test. The results showed that most respondents experienced side effects such as weight changes, irregular menstrual cycles, vaginal discharge, and facial pigmentation, which led to discomfort in daily activities. Out of 15 respondents, 9 (60%) discontinued LTCM use due to these side effects. Statistical analysis indicated a significant relationship between side effects and the incidence of LTCM discontinuation (p < 0.05). In conclusion, there is a significant correlation between side effects and the dropout rate of LTCM use. Therefore, improving the quality of counseling services before and after contraceptive use is crucial to reduce dropout rates and enhance the effectiveness of the family planning program.

THE EFFECT OF CULTURE ON MATERNAL LIFESTYLE DURING PREGNANCY ON THE INCIDENCE OF STUNTING IN TODDLERS AGED 1-3 YEARS IN THE WORKING AREA OF HILISATARO HEALTH CENTER, TOMA DISTRICT, SOUTH NIAS REGENCY, NORTH SUMATERA PROVINCE, 2025

Thu, 08 Jan 2026 00:00:00 +0700

Background: Food taboos and cultural beliefs and practices of mothers during pregnancy have negative impacts on the mother and her unborn baby, causing the baby to be malnourished and at risk of stunting. Method: This study used an observational method with a case-control research design. simple random sampling technique. The subjects of the study were biological mothers of toddlers aged 1-3 years in the Hilisataro Health Center Working Area, Toma District, South Nias Regency, North Sumatra Province, totaling 114 respondents. The study's independent variables were maternal food taboos during pregnancy and maternal cultural beliefs and practices during pregnancy, obtained using a questionnaire. Results: The study showed that 50.0% of maternal food taboos during pregnancy were in the good category and there was a significant influence OR 72.250 (p = 0.001) on the stunting status of toddlers and maternal cultural beliefs and practices during pregnancy were 50.9% in the good category and there was a significant influence OR 88.400 (p = 0.001) on the stunting status of toddlers Conclusion: There is an influence of maternal food taboos during pregnancy on stunting and there is an influence of maternal cultural beliefs and practices during pregnancy on child stunting.

CONTINUITY OF CARE WITH A RUPTURE OF THE PERINEUM OF THE SECOND DEGREE IN MRS. F AT THE FRISKA NOVITA PRIMARY CLINIC, MEDAN DISTRICT LABUHAN DELI SERDANG REGENCY YEAR 2025

Thu, 08 Jan 2026 00:00:00 +0700

Background: Perineal rupture is a prevalent obstetric complication, affecting nearly half of global births according to WHO and UNICEF data. It poses significant risks for postpartum hemorrhage and infection, contributing to maternal morbidity rates in Indonesia. Proper management of perineal wounds is crucial to prevent long-term disability and ensure maternal safety.Objective: This study aims to provide and evaluate comprehensive midwifery care for a postpartum patient experiencing a second-degree perineal rupture, utilizing the Continuity of Care (CoC) model and Varney’s seven-step management method.Methods: A descriptive qualitative case study was conducted at Pratama Friska Novita Clinic, Medan, from October 2024 to February 2025. The subject was Mrs. F, a 30-year-old primipara (G1P0A0). Data were collected via observation, physical examination, and interviews. The study followed the patient longitudinally from the third trimester of pregnancy through labor and the puerperium (postpartum period). Results: Mrs. F experienced a second-degree perineal rupture attributed to straining prior to complete cervical dilation during labor. Management involved immediate suturing followed by comprehensive postpartum care. Interventions focused on infection prevention through perineal hygiene education, pain management, and nutritional counseling emphasizing high protein and fiber intake to support tissue repair. The evaluation indicated that the wound healed effectively within the standard 6–7 day timeframe without signs of infection, and the mother reported reduced pain and improved comfort.Conclusion: Comprehensive midwifery care proved effective in managing second-degree perineal ruptures. The study found no discrepancy between theoretical standards and the clinical management provided. It is concluded that proper education on pushing techniques during labor and meticulous postpartum wound care are critical for optimal recovery.

CONTINUOUS MIDWIFERY CARE (CONTINUITY OF CARE) ON NY. W WITH MILK DAM AT THE FRISKAH NOVITA PRIMARY CLINIC MEDAN LABUHAN DISTRICT KABUPATEN DELI SERDANG YEAR 2025

Thu, 14 Aug 2025 00:00:00 +0700

Breast milk dam is an increase in venous and lymphatic flow in the breast in order to prepare for lactation. This is not due to overdistension of the ducts of the lactation system of the dam due to overflowing of the lymphatic and venous dams before lactation. This study focuses on the relationship between the level of knowledge and the case of breastfeeding dams during the postpartum period. The main cause of the breast milk dam is the mother's fluid milk output and the frequency of mothers breastfeeding their children is low so that there is a narrowing of the lactive duct, This case study describes the handling of the breast milk dam in Mrs. W at the age of 32 years. The care provided is to do breast massage and provide KIE about breastfeeding on demen ( once every 2 hours of breastfeeding) The purpose: of this service is to increase the mother's understanding of the prevention and handling of breast milk dams in mothers at the Pratama Friska Novita clinic. Methods: The method used in this study is education and administration of Fe tablets. The results of this study show an increase in pregnant women's knowledge about breast milk dams and how to handle them. In conclusion, provide counseling and perform breast massage actions in handling cases in this region.

EXCELLENT NURSING CARE MANAGEMENT SERVICES FOR MRS.F WITH SUICIDE RISK AT PROF. Dr. MUHAMMAD ILDREM MENTAL HOSPITAL, MEDAN, NORTH SUMATRA PROVINCE, IN 2025

Thu, 08 Jan 2026 00:00:00 +0700

Suicide risk is a critical complication among patients with psychiatric disorders, particularly those diagnosed with hebephrenic schizophrenia. This study aims to delineate the implementation of psychiatric nursing care integrated with service excellence principles for Mrs. F, a patient at high risk for suicide at Prof. Dr. Muhammad Ildrem Mental Hospital, Medan. Case study design was employed, with data triangulated through clinical observation, in-depth interviews, and medical record documentation. The initial assessment revealed profound hopelessness, perceived worthlessness, social withdrawal, and a documented history of suicidal behavior. The established nursing diagnoses were Suicide Risk, Risk for Self-Directed Violence, and Chronic Low Self-Esteem. Interventions focused on service excellence through structured relaxation training, cognitive restructuring to bolster self-worth, and the fortification of adaptive coping mechanisms. Following a three-day intensive implementation, evaluation results demonstrated a significant reduction in suicidal ideation and an enhanced capacity for emotional regulation. A psychiatric nursing care model rooted in service excellence effectively mitigates suicide risk and optimizes the quality of life for patients with complex mental disorders

THE RELATIONSHIP BETWEEN AGE FACTORS AND THE INCIDENCE OF ANEMIA IN PREGNANT WOMEN AT PMB PRATAMA MADINA MEDAN TEMBUNG DELI SERANG REGENCY IN 2024

Thu, 14 Aug 2025 00:00:00 +0700

Anemia pada ibu hamil masih menjadi masalah kesehatan masyarakat yang berdampak signifikan terhadap kesehatan ibu dan janin. Anemia pada kehamilan terutama disebabkan oleh defisiensi zat besi, namun kondisi ini juga dipengaruhi secara signifikan oleh status gizi ibu secara keseluruhan. Penelitian ini bertujuan untuk mengetahui hubungan antara usia dan kejadian anemia pada ibu hamil di PMB Pratama Madina Medan Tembung, Kabupaten Deli Serdang pada tahun 2024. Penelitian ini menggunakan desain cross-sectional. Populasi penelitian adalah 32 ibu hamil di PMB Pratama Madina Medan Tembung, Kabupaten Deli Serdang. Ukuran sampel adalah 32 orang yang diperoleh dengan menggunakan total sampling. Teknik analisis data yang digunakan adalah analisis chi-square. Hasil yang diperoleh dalam penelitian ini adalah dari 32 responden, terdapat hubungan antara usia dan kejadian anemia pada ibu hamil di PMB Pratama Madina Medan Tembung, Kabupaten Deli Serdang pada tahun 2024, dengan nilai p sebesar 0,003 (p-value <0,05).

FACTORS INFLUENCING LOW ANTENATAL CARE VISITS AT THE PAMAR COMMUNITY HEALTH CENTER IN THE DISTRICT HEALTH CENTER RUSIP BETWEEN CENTRAL ACEH DISTRIC ACEH PROVINCE IN 2025

Thu, 14 Aug 2025 00:00:00 +0700

Background: The persistently high MMR and IMR in Indonesia necessitate robust intervention, specifically through mandated Antenatal Care (ANC) visits. In the Rusip Antara Subdistrict, particularly at the Pamar Public Health Center, there is a documented shortfall in first-trimester ANC participation. Objective: The study sought to investigate the variables behind this low attendance within the Central Aceh Regency in 2025.Methods: The investigation was designed as an analytical observational study with a cross-sectional framework. The researchers utilized a total sampling technique, involving 40 pregnant women who had completed their first trimester. Data gathered via structured questionnaires were processed through Chi-square analysis to determine variable relationships. Results: Statistical testing revealed that education, knowledge, and attitude significantly influenced ANC visits, while cultural influences remained statistically insignificant (p=0.744). Conclusion: Because education and attitude are primary predictors of healthcare seeking, the Pamar Public Health Center should prioritize targeted health education to enhance maternal engagement with prenatal services.

THE RELATIONSHIP BETWEEN THE FULFILLMENT OF THE NUTRITIONAL STATUS OF POSTPARTUM MOTHERS AND THE PROCESS OF HEALING WOUNDS IN THE PERINEUM AT BPM AYANG LESTARI, SIMALUNGUN REGENCY, UJUNG PADANG DISTRICT NORTH SUMATRA PROVINCE IN 2024

Thu, 14 Aug 2025 00:00:00 +0700

Background: The puerperium represents a critical phase of maternal recovery, necessitating specialized oversight—particularly regarding the repair of perineal lacerations. It is hypothesized that a mother’s nutritional profile serves as a primary determinant in either accelerating or obstructing the physiological healing of such wounds. Objective: This research was designed to evaluate the correlation between maternal nutritional intake and the recovery rate of perineal wounds at BPM Ayang Lestari, Simalungun Regency, North Sumatra, in 2024.Methods: Adopting a quantitative framework with a cross-sectional design, the study focused on a population of postpartum women presenting with perineal lesions at the facility. Participants were selected via a purposive sampling technique. Data acquisition involved a combination of structured interviews and clinical observations, with the subsequent analysis utilizing the Chi-square statistical test to identify inter-variable relationships.Results: The findings demonstrated that mothers with optimal nutritional standing exhibited significantly faster wound closure compared to those with poor nutritional status. Statistical analysis confirmed a significant association between these variables (p < 0.05). Conclusion: There is a definitive link between nutritional fulfillment and the efficacy of perineal wound healing. Consequently, prioritizing nutritional surveillance during the postpartum period is essential for enhancing midwifery care quality and mitigating the risk of long-term obstetric complications.

CONTINUITY OF CARE OF MRS. M WITH PERINEAL RUPTURE TITLE II AT PRATAMA NIAR CLINIC, MEDAN AMPLAS DISTRICT, MEDAN CITY IN 2025

Thu, 14 Aug 2025 00:00:00 +0700

Perineal rupture is one of the common complications of childbirth that may cause bleeding and infection if not properly managed. Continuity of care in midwifery is essential to ensure maternal and neonatal safety from pregnancy through family planning services. This article aims to describe the implementation of continuity of midwifery care for Mrs. M with a second-degree perineal rupture at Niar Primary Clinic, Medan City. This study employed a descriptive case study design using a continuity of care approach. The subject was Mrs. M, a 24-year-old woman (G3P2A0), who received comprehensive midwifery care starting from the third trimester of pregnancy, labor, postpartum period, newborn care, to family planning services. Data were collected through interviews, observations, physical examinations, and documentation. The results showed that maternal and fetal conditions during pregnancy were within normal limits. Labor occurred spontaneously through vaginal delivery with a second-degree perineal rupture, which was managed according to standard midwifery procedures. The postpartum period and newborn care proceeded without complications. The mother chose an appropriate postpartum family planning method. In conclusion, continuity of midwifery care was successfully implemented and contributed to optimal outcomes for both mother and baby.

GERIATRIC NURSING CARE MANAGEMENT WITH SERVICE EXCELLENCE FOR MR. A WITH GOUT ARTHRITIS AT UPTD SOCIAL SERVICES THE ELDERLY BINJAI, NORTH SUMATRA PROVINCE

Thu, 14 Aug 2025 00:00:00 +0700

Fase lanjut usia ditandai dengan penurunan progresif fungsi fisiologis dan kognitif, meningkatkan kerentanan terhadap penyakit degeneratif seperti artritis gout (Yaslina dkk., 2021). Artritis gout adalah kondisi peradangan sendi yang disebabkan oleh akumulasi kristal monosodium urat, yang mengakibatkan nyeri hebat, pembengkakan, dan gangguan mobilitas sendi (Gulbudin dan Larasati, 2019). (PRI, 2020). Studi ini bertujuan untuk memberikan perawatan keperawatan geriatri holistik berdasarkan model keunggulan layanan kepada Bapak A, seorang warga berusia 72 tahun dengan artritis gout kronis. Metode studi kasus deskriptif menggunakan proses keperawatan diterapkan, termasuk asesmen, diagnosis, perencanaan, implementasi, dan evaluasi. Data dikumpulkan melalui wawancara, pemeriksaan fisik, dan dokumentasi (Ningrum dkk., 2023). Masalah keperawatan utama yang diidentifikasi adalah nyeri kronis, gangguan mobilitas fisik, dan gangguan pola tidur (Panti dkk., 2024). Intervensi yang dilakukan meliputi terapi farmakologis, kompres hangat, latihan rentang gerak, dan edukasi diet (Murwani dkk., 2022); (Madyaningrum dkk., 2020). Evaluasi menunjukkan penurunan nyeri, peningkatan mobilitas, dan kualitas tidur yang lebih baik (Rahmatica dkk., 2023). Penerapan kerangka kerja keunggulan layanan PACER menunjukkan hasil fisik dan psikologis yang positif (Purwanza dkk., 2023).

ANALYSIS OF FACTORS AFFECTING CAESAREAN SURGERY DELIVERY IN THE PRACTICE OF MIDWIFE NURHAYANI NASUTION, KAMPUNG RAKYAT DISTRICT, SOUTH LABUHANBATU REGENCY IN 2023

Thu, 08 Jan 2026 00:00:00 +0700

The number of deliveries by cesarean section (CS) continues to increase, including in primary healthcare settings such as independent midwifery practices. This is concerning because the World Health Organization (WHO) recommends an ideal cesarean section rate of around 10–15% of all deliveries. Independent midwife Nurhayani Nasution's practice in Kampung Rakyat District, South Labuhanbatu Regency, showed an increase in referrals for cesarean deliveries during 2023.
This research is quantitative, using statistical techniques to measure something. The process of seeking knowledge that uses numerical data as a tool to analyze what one wants to know is called quantitative research methodology.(Sujarweni, 2022)The method used in this study is analytical with a cross-sectional approach, which examines the dynamics of the correlation between risk factors and their effects through observation or collective data collection. This study aims to analyze the factors influencing the decision or referral for cesarean section delivery by independent midwives.
Factors influencing CS delivery include medical factors (history of previous CS, preeclampsia, CPD, fetal distress), sociocultural factors (family request, fear of pain), and service factors (the midwife's ability to detect complications). A history of previous CS was the dominant factor (30%), followed by family request (20%).
CS deliveries in independent midwifery practices are influenced by various factors, both clinical and non-clinical. An educational approach and improved communication between midwives and patients are needed to ensure that CS decisions are based on appropriate medical indications.

CONTINUITY OF CARE FOR PREGNANT WOMEN WITH A BREAST MILK DAM AT PRATAMA NIAR CLINIC, MEDAN AMPLAS DISTRICT, MEDAN CITY YEAR 2025

Thu, 14 Aug 2025 00:00:00 +0700

The ASI Dam is an event A the flow of venous blood vessels and lymph nodes is blocked, the flow of milk is blocked, and the pressure on the vessels and alveoli increases. Symptoms that often appear during breast milk dams include swollen breasts, breasts that feel hot and hard, breasts that feel painful when pressed, reddish breasts and mother's body temperature up to 38 C. If this continues, breast milk retention can occur, and it can also speed up the process of giving breast milk to mothers and children in a relaxed atmosphere. Make your room as comfortable as possible. Babies need breast milk every 2.5-3 hours for the first few weeks. By the end of the sixth week, most babies need milk every 4 hours. This program is good until babies are 10-12 months old. At this age, most babies sleep through the night, so there is no need to breastfeed at night (Ariandini 2023). In conclusion, education and intervention do the correct breastfeeding techniques and do breascare

CONTINUOUS OBSTETRIC CARE (CONTINUITY OF CARE) WITH UMBILICAL CORD WRAPPING IN MRS. N IN THE INDEPENDENT PRACTICE OF SUMIATI NORTH LABUHAN BATU REGENCY

Thu, 14 Aug 2025 00:00:00 +0700

The Maternal Mortality Rate (MMR) and Infant Mortality Rate (AKB) in Indonesia are still a big challenge in an effort to realize the golden generation of 2045. Continuous midwifery services, or Continuity of Care (CoC), is a strategic approach to improve the quality of pregnancy care, childbirth, postpartum care, newborn care, and family planning. This case study aims to provide a comprehensive overview of midwifery care for Mrs. N, a pregnant woman with an umbilical cord circumference, delivered continuously at PMB Sumiati, Kualuh Hulu District. This study uses a qualitative descriptive approach with case study methods and management of midwifery care based on Varney. The results of the care showed that CoC was able to detect complications early, provide appropriate action at the time of delivery with umbilical cord wrapping, and improve maternal understanding of postpartum care and contraceptive use. This approach not only improves service quality but also builds an empathetic relationship between midwives and patients, ultimately supporting efforts to reduce AKI and AKB significantly.

THE RELATIONSHIP BETWEEN SOCIO-ECONOMIC STATUS AND THE USE OF SUBDERMAL CONTRACEPTIVE IMPLANTS (AKBK) AT BIAK MULI COMMUNITY HEALTH CENTER, BAMBEL SUB-DISTRICT, SOUTHEAST ACEH DISTRICT IN 2024

Thu, 14 Aug 2025 00:00:00 +0700

Latar Belakang: Pertumbuhan penduduk di Indonesia tetap tinggi, sebagian disebabkan oleh rendahnya penggunaan metode kontrasepsi jangka panjang seperti implan subdermal (AKBK). Data nasional menunjukkan hanya 8,5% pasangan usia reproduktif yang menggunakan AKBK, dan di Sumatera Utara, angkanya mencapai 12,05%. Survei pendahuluan di Puskesmas Biak Muli pada tahun 2024 menemukan bahwa keterbatasan ekonomi dan kurangnya pengetahuan berkontribusi pada rendahnya penggunaan AKBK. Penelitian ini bertujuan untuk meneliti hubungan antara status sosial ekonomi dan penggunaan AKBK. Tujuan: Penelitian ini bertujuan untuk mengetahui hubungan antara status sosial ekonomi dan penggunaan implan kontrasepsi subdermal (AKBK) di Puskesmas Biak Muli, Kecamatan Bambel, Kabupaten Aceh Tenggara pada tahun 2024. Metode: Penelitian observasional analitik dengan desain cross-sectional dilakukan. Populasi terdiri dari 39 wanita usia reproduktif yang mengunjungi Puskesmas Biak Muli. Pengambilan sampel total digunakan. Status sosial ekonomi diukur berdasarkan pendapatan relatif terhadap upah minimum daerah. Uji Chi-Square digunakan untuk menilai hubungan antara status sosial ekonomi dan penggunaan AKBK. Hasil: Mayoritas responden memiliki status sosial ekonomi rendah (53,8%) dan tidak menggunakan AKBK (61,5%). Uji statistik menunjukkan hubungan yang signifikan antara status sosial ekonomi dan penggunaan AKBK (p = 0,007). Kesimpulan: Terdapat hubungan yang signifikan antara status sosial ekonomi dan penggunaan implan kontrasepsi subdermal. Wanita dengan status ekonomi yang lebih tinggi lebih cenderung menggunakan AKBK.

CONTINUITY OF CARE IN MRS. R WITH 1ST DEGREE BIRTH DUCT LACERATION AT PMB SUMIATI, KUALA HULU DISTRICT CITY OF AEK CANOPAN PROVINCE NORTH SUMATRA IN 2025

Thu, 14 Aug 2025 00:00:00 +0700

Maternal health remains a crucial public health concern, particularly in reducing maternal and neonatal mortality as targeted by the Sustainable Development Goals (SDGs). Birth canal lacerations frequently occur during vaginal delivery and may affect maternal recovery if not managed appropriately.(Arnold, Sadler and Lacerations, 2021) This study aimed to describe the implementation of Continuity of Care in a mother experiencing a first-degree birth canal laceration at PMB Sumiati, Kuala Hulu District, Aek Canopan City, North Sumatra Province. This case study was conducted from September 2024 to March 2025 using direct midwifery care and documentation review. The subject was Mrs. R (G2P1A0) at 39 weeks of gestation who underwent spontaneous vaginal delivery following the 58-step Normal Childbirth Care (APN) standard. The newborn was delivered safely, and the third stage of labor was completed within normal limits.(Sinaga,A 2022) During the fourth stage of labor monitoring, the mother’s vital signs were stable; however, a first-degree birth canal laceration was identified. Continuous and comprehensive midwifery care, including appropriate laceration management, monitoring, and postpartum education, was provided. The results showed that the mother experienced optimal recovery without complications such as infection or excessive bleeding. In conclusion, the Continuity of Care approach is effective in ensuring safe childbirth and supporting maternal recovery in cases of minor obstetric complications, thereby contributing to improved quality of maternal health services.

CONTINUITY OF MIDWIFERY CARE FOR MRS. D, 24 YEARS OLD, WITH MODERATE ANEMIA AT PMB PERA, MEDAN TUNTUNGAN DISTRICT, MEDAN CITY, IN 2025

Thu, 14 Aug 2025 00:00:00 +0700

Anemia pada ibu hamil merupakan salah satu penyebab utama morbiditas dan mortalitas ibu di Indonesia. Berdasarkan data awal dari PMB Pera, Kabupaten Medan Tuntungan, 3 dari 15 ibu hamil yang diperiksa mengalami anemia, menunjukkan bahwa masalah ini masih signifikan. Laporan akhir ini bertujuan untuk memberikan layanan kebidanan Kontinuitas Perawatan (CoC) kepada Ibu D, usia 24 tahun, dengan anemia sedang, yang meliputi kehamilan, persalinan, masa pascapersalinan, perawatan bayi baru lahir, dan keluarga berencana. Metode yang digunakan adalah studi kasus berdasarkan kerangka manajemen kebidanan Varney, yang didokumentasikan menggunakan format SOAP. Hasil perawatan menunjukkan bahwa dengan layanan yang tepat dan berkelanjutan, kondisi ibu dapat dipantau secara menyeluruh, anemia dapat dikelola secara efektif, dan komplikasi dapat dicegah. Implementasi CoC juga terbukti efektif dalam meningkatkan pengetahuan ibu tentang pentingnya nutrisi, penggunaan tablet zat besi, dan layanan kesehatan rutin selama dan setelah kehamilan.

THE RELATIONSHIP BETWEEN THE NUTRITIONAL STATUS OF POSTPARTUM WOMEN AND THE WOUND HEALING PROCESS POST SECTIO CAESAREA AT TANJUNG PURA HOSPITAL IN 2024

Thu, 14 Aug 2025 00:00:00 +0700

Background: Cesarean delivery is a surgical procedure that carries specific postoperative risks, particularly regarding suboptimal wound recovery. A patient's nutritional health is a critical determinant in this process; insufficient nutrient intake can impede cellular regeneration, suppress immune response, and elevate the likelihood of infection, ultimately extending the recovery period . Objective: This study aimed to evaluate the link between nutritional profiles and surgical wound closure among postpartum patients at Tanjung Pura Langkat Hospital in 2023. Methods: Employing an analytical survey with a cross-sectional design, the research involved 30 subjects selected via purposive sampling. Nutritional status was evaluated using mid-upper arm circumference (MUAC), while the REEDA scale served as the assessment tool for wound healing. Data were analyzed using the chi-square test (p<0.05). Results: The findings indicated that 66.6% of respondents maintained normal nutrition, whereas 33.3% were identified with Chronic Energy Deficiency (CED). Notably, optimal healing was achieved by all participants with healthy nutritional status, while delayed recovery was prevalent among those with CED. Statistical analysis confirmed a significant correlation (p=0.000). Conclusion: There is a definitive relationship between nutritional status and the healing of post-CS wounds. Consequently, ensuring balanced nutrition is essential for accelerating recovery and improving clinical outcomes

THE RELATIONSHIP BETWEEN KNOWLEDGE LEVEL AND ATTITUDE OF ADOLESCENTS TOWARDS THE BEHAVIOR OF THREE BASIC THREATS TO ADOLESCENT REPRODUCTIVE HEALTH (TRIAD KRR) IN BANGUN REJO VILLAGE, TANJUNG MORAWA DISTRICT IN 2025

Thu, 14 Aug 2025 00:00:00 +0700

Introduction : Teenagers is the growing period flower child transition from childhood into adulthood (Bawono, 2023) . According to WHO, the age teenagers aged 10-19 years However according to opinion other distribution teenager can until age 21 , namely teenager early 10-13 years , middle 14-17 and late 18-21 years . KRR is Reproductive Health Teenager that is all matters concerning tool reproduction teenager Good in terms of organs, processes, even function reproduction teenager in a way physical , social and psychological . The KRR Triad is 3 threats health reproduction that always felt teenager that is sexuality , HIV, drugs and sexuality . Objective : to analyze the knowledge, attitudes and behavior of the KRR Triad in Bangun Rejo Village in 2025. Method : This research is an analytical survey with a cross-sectional design . Population and Sample: all teenagers in Bangun Rejo village in 2025, namely 80 people. Sampling using the Slovin Formula, so the sample is 44 people, the sampling technique is accidental according to the inclusion and exclusion criteria. Place and time: Bangun Rejo Village Rejo, Tanjung Morawa District month February until May 2025. Results : Univariate : Majority age respondents be in range 14-17 years old as many as 19 people (43%). Reviewed from type sex majority Woman as many as 23 people (52%), the majority respondents knowledge not enough as many as 20 people (45%). Attitude respondents majority behave negative as many as 25 people ( 55 %), Respondents majority Behavior No preventing the KRR Triad from killing 20 people ( 45 %) Bivariate : Chi square test, namely the results analysis obtained with p -value = 0.000 ( p<0.05) then There is connection knowledge and attitudes teenager to Triad KRR behavior in Bangun Rejo Village in 2025. Conclusion There is a Relationship knowledge with attitude teenager in To KRR Triad Behavior in Village wake up rejo Subdistrict cape Morawa Suggestion : Need done education in increase knowledge and making attitude teenager the more positive to behavior KRR Triad prevention

THE EFFECT OF WARM COMPRESS ON THE INTENSITY OF LABOR PAIN IN THE ACTIVE PHASE OF THE FIRST STAGE IN THE PRATAMA CLINIC AFISYA PERCUT SEI TUAN DISTRICT IN 2025

Thu, 14 Aug 2025 00:00:00 +0700

Pain in thel activel phasel of first stagel of labor is a physiological elxpelrielncel that can causel discomfort and anxielty in laboring mothelrs. Non-pharmacological pain managelmelnt such as warm comprelssels is bellielveld to bel elffelctivel in relducing pain intelnsity with minimal risk. This study aims to analyzel thel elffelct of warm comprelssels on thel intelnsity of pain in thel activel phasel of first stagel of labor at thel Villagel Helalth Post (Poskelsdels) in Pelnanggoan Dureln Villagel, Palelmbang City. Thel study useld a quasi-elxpelrimelntal delsign with a onel-group preltelst-posttelst delsign. Thel study samplel was 30 mothelrs in thel activel phasel of first stagel labor who welrel divideld into trelatmelnt groups (n=15) and control groups (n=15) with a total sampling telchniquel. Pain was melasureld using thel Numelric Rating Scalel (NRS) belforel and aftelr thel intelrvelntion. Data analysis was pelrformeld using a paireld t-telst. Thel relsults showeld a delcrelasel in thel pain scalel in thel trelatmelnt group from an avelragel of 3.93 to 3.53, with p=0.011 (p<0.05), which melans thelrel is a significant elffelct of warm comprelssels on relducing thel intelnsity of pain in thel activel phasel of first stagel of labor. Conclusion: Warm comprelssels can bel useld as an elffelctivel non-pharmacological intelrvelntion to relducel pain in thel activel phasel of first stagel of labor.

THE EFFECTIVENESS OF USING A WEARABLE BREAST PUMP TO INCREASE BREAST MILK PRODUCTION AND BREASTFEEDING COMFORT AMONG WORKING MOTHERS AT ROSALINA MUNTHE PRIMARY CLINIC, KWALA BEKALA, MEDAN JOHOR DISTRICT, NORTH SUMATRA PROVINCE IN 2025

Thu, 14 Aug 2025 00:00:00 +0700

Many working mothers struggle to maintain exclusive breastfeeding because of time constraints and inadequate lactation facilities. The wearable breast pump is a technological innovation designed to improve breast milk production and breastfeeding comfort, especially for working mothers. Objective: To determine the effectiveness of wearable breast pump use in increasing breast milk production and breastfeeding comfort among working mothers at Klinik Pratama Rosalina Munthe, Kwala Bekala, Medan Johor. Methods: This study used a pre-experimental one-group pre-test and post-test design. A total of 40 breastfeeding working mothers were selected using accidental sampling. Instruments included breast milk volume logs and a breastfeeding comfort questionnaire. Data were analyzed using the Wilcoxon test and Spearman correlation. Results: Following the use of a wearable breast pump, there was a significant increase in both breast milk production (p=0.000) and breastfeeding comfort (p=0.000). A strong positive correlation was also observed between breastfeeding comfort and milk production (r=0.654; p=0.000). Conclusion: The wearable breast pump is effective in increasing breast milk production and breastfeeding comfort among working mothers. It serves as a strategic solution to support successful breastfeeding in the context of employment.

Keyword: wearable breast pump; working mothers; breast milk production; breastfeeding comfort

THE EFFECT OF LEMON AROMATHERAPY PILLOW ON ANXIETY IN POST HAEMODIALYSIS PATIENTS

handoyo, Hartati, Herry Prasetyo — Fri, 29 Aug 2025 00:00:00 +0700

ABSTRAK

Hemodialisis merupakan terapi penunjang ginjal bagi pasien yang menderita penyakit ginjal kronis. Prosedur hemodialisis terkadang menimbulkan dampak psikologis pada pasien tersebut. Kondisi yang umum muncul adalah kecemasan. Penanganan non-medis yang dapat mengurangi kecemasan pasca hemodialisis adalah dengan menggunakan aromaterapi lemon (Citrus Aurantium) yang bersifat sedatif dan limonene yang dapat melancarkan peredaran darah. Unsur aromatik dalam lemon akan menstimulasi memori dan respons emosional di hipotalamus sehingga menimbulkan perasaan tenang, rileks, serta mengurangi kecemasan, stres, dan resistensi perifer pembuluh darah. Tujuan penelitian ini adalah untuk mengetahui pengaruh bantal aromaterapi lemon terhadap kecemasan pada pasien pasca hemodialisis. Penelitian ini menggunakan desain penelitian kuantitatif quasi eksperimen dengan rancangan pre-post test one group design. Sampel dalam penelitian ini adalah seluruh pasien pasca hemodialisis di panti jompo paliatif Purwokerto Timur dengan total sampling sebanyak 35 responden. Instrumen yang digunakan untuk mengukur kecemasan adalah kuesioner Hamilton Anxiety Rating Scale (HARs). Analisis data menggunakan uji t berpasangan. Hasil uji statistik menunjukkan adanya efek bantal aromaterapi lemon terhadap kecemasan pada pasien pasca hemodialisis (p = 0,000 < α = 0,05). Kesimpulan penelitian ini adalah bantal aromaterapi lemon dapat menjadi terapi komplementer nonfarmakologis pada pasien pasca hemodialisis.

ASSOCIATION OF SPOUSAL SUPPORT AND SOCIOECONOMIC STATUS WITH MATERNAL ANEMIA

Sharfina Haslin, Netti Meilani Simanjuntak, Juneris Aritonang — Mon, 08 Sep 2025 00:00:00 +0700

Anemia dalam kehamilan merupakan salah satu komplikasi yang paling umum ditemui dalam perawatan antenatal dan tetap menjadi kontributor utama morbiditas ibu dan hasil kehamilan yang buruk. Di Indonesia, prevalensi anemia di antara wanita hamil telah mencapai 48,9%, memberikan kontribusi yang signifikan terhadap morbiditas ibu dan janin. Penelitian ini bertujuan untuk menguji hubungan antara dukungan pasangan dan status sosial ekonomi dengan kejadian anemia pada wanita hamil. Sebuah studi potong lintang dilakukan dari Mei hingga Juni 2025 di PMB Misykah. Total sampling diterapkan pada 45 wanita hamil di trimester kedua dan ketiga mereka yang memenuhi kriteria inklusi. Data dikumpulkan menggunakan kuesioner terstruktur dan data sekunder dari buku KIA. Variabel termasuk dukungan pasangan, status sosial ekonomi, dan status anemia berdasarkan kadar hemoglobin terakhir yang tercatat. Data dianalisis menggunakan analisis Chi-square dengan tingkat signifikansi p<0,05. Hasil penelitian menunjukkan bahwa 55,6% responden mengalami Anemia. Ditemukan hubungan yang signifikan antara dukungan pasangan dan anemia (p=0,014), serta antara status sosial ekonomi dan anemia (p=0,008). Temuan ini menunjukkan bahwa determinan sosial dan ekonomi merupakan faktor kunci yang berkontribusi terhadap anemia ibu. Oleh karena itu, program kesehatan ibu sebaiknya tidak hanya berfokus pada intervensi klinis, tetapi juga melibatkan suami dalam perawatan antenatal dan meningkatkan ketahanan ekonomi keluarga. Penelitian lebih lanjut diperlukan untuk mengeksplorasi mekanisme yang mendasarinya melalui studi longitudinal atau metode campuran.

THE RELATIONSHIP BETWEEN WEIGHT GAIN AND THE INCIDENCE OF PREECLAMPSIA IN PREGNANT WOMEN IN THE WORKING AREA OF THE RUNDENG PUBLIC HEALTH CENTER UPTD, RUNDENG DISTRICT, SUBULUSSALAM CITY IN 2025

Mon, 18 Aug 2025 00:00:00 +0700

The utilization of maternal and child health services is still constrained by the low level of mothers’ knowledge and attitudes regarding the danger signs of pregnancy, as well as the use of the Maternal and Child Health (MCH) handbook. According to the 2020 RISKESDAS report, analysis showed that 60% of mothers brought the MCH handbook during antenatal care visits, 10% did not bring it, and 30% did not have the handbook at all. One of the efforts to reduce the Maternal Mortality Rate (MMR) is through the implementation of the MCH handbook program. The purpose of this study was to determine the relationship between pregnant women’s knowledge and attitudes regarding pregnancy danger signs and the utilization of the MCH handbook in the working area of UPTD Longkib Health Center, Subulussalam City, in 2024.

This study employed an analytic design with a cross-sectional approach, using both primary and secondary data. The population consisted of all pregnant women who owned an MCH handbook and resided in the working area of UPTD Longkib Health Center, totaling 542 individuals. The sampling technique used was random sampling, resulting in 84 respondents. The research instrument was a questionnaire.

The results of the study showed that of the 84 respondents, 35 (41.7%) had good knowledge, while 43 (48.8%) had negative attitudes. Statistical analysis using the Chi-square test with a 95% confidence level (df = 1) revealed a significant relationship between knowledge (p = 0.004 < 0.05) and attitudes (p = 0.004 < 0.05) of pregnant women regarding pregnancy danger signs and the utilization of the MCH handbook in the working area of UPTD Longkib Health Center, Subulussalam City, in 2024.

It is recommended that health workers provide counseling and health education through health promotion activities for pregnant women regarding the danger signs of pregnancy and the benefits of the MCH handbook.

FACTORS RELATED TO PARENTING PATTERNS IN PROVIDING NUTRITION TO MOTHERS HAVING TODDLER CHILDREN

Wed, 24 Sep 2025 00:00:00 +0700

Background: Nutritional problems that frequently occur in toddlers ( 1–3 years) include undernutrition, overnutrition, and nutritional imbalance. This can be caused by problems with maternal parenting patterns regarding nutritional provision. not enough Good. Factors suspected to be related are education, family income, occupation, and maternal knowledge.

Objective: To determine factors related to parenting patterns in providing nutrition to they mom.

Method: Descriptive correlation with cross section . In Teluk Karang Subdistrict, Tebing Tinggi City. The population in this study were mothers who had toddler age toddler (1-3 year) in Teluk Karang Village 32 people and all were sampled. Data were analyzed univariately and bivariately using the chi-square test with a 95% confidence level (=0.05).

Results : This study show that factors related to patterns foster care in giving nutrition child age toddler (age 1-3 year) in Teluk Karang Subdistrict, Tebing Tinggi City. is education p = 0.001, income ( p = 0,000, work p = 0,000 , knowledge p= 0,000 all < 0,05).

Conclusion : Education, income family , work , and knowledge Mother relate with pattern foster care in giving nutrition child age toddler (1-3 years ). Recommended to power health For give education to mother who has child age toddler (1-3 years ) to have good knowledge and do pattern good parenting in giving nutrition

FACTORS RELATED TO PREGNANCY WOMEN'S PARTICIPATION IN CHILD PREPARATION CLASS AT THE PEUREULAK PUBLIC HEALTH CENTER, EAST ACEH REGENCY, ACEH PROVINCE 2024

Thu, 14 Aug 2025 00:00:00 +0700

The Maternal Mortality Rate (MMR) serves as an essential indicator of national health performance and development. In Aceh Province, MMR showed fluctuations from 2018 to 2022, with a marked decline to 141 deaths per 100,000 live births in 2022. Aceh Timur Regency reported the highest number of maternal deaths, totaling 14 cases, whereas no maternal deaths were recorded in Sabang City. This quantitative correlational study was conducted in 2024 involving 50 respondents from the UPTD Peureulak Community Health Center in Aceh Timur. The study aimed to analyze the effect of antenatal class participation factors—namely knowledge, attitude, and employment status—on childbirth preparation. The findings revealed statistically significant associations between these factors and birth preparedness, with a p-value of 0.000 (p < 0.05), indicating that involvement in antenatal classes has a substantial influence on readiness for delivery. In conclusion, maternal knowledge, attitudes, and occupational status related to antenatal class participation play a critical role in enhancing childbirth preparation among pregnant women in Aceh Timur

EXCELLENT NURSING CARE MANAGEMENT FOR A CHILD WITH PNEUMONIA IN RESIDENTIAL ROOM 4, H. ADAM MALIK GENERAL HOSPITAL, MEDAN, NORTH SUMATERA PROVINCE 2025

Thu, 14 Aug 2025 00:00:00 +0700

Pneumonia remains a leading cause of morbidity and mortality among children under five, particularly in developing countries. This scientific paper presents a case study on the implementation of comprehensive nursing care using a service excellent approach for a pediatric patient (An. A) treated in RB4 Ward at H. Adam Malik General Hospital, Medan, in 2025.A descriptive method with a case study approach was applied, covering the five stages of the nursing process: assessment, diagnosis, planning, implementation, and evaluation. Based on the assessment, four primary nursing diagnoses were identified: ineffective airway clearance, ineffective breathing pattern, hyperthermia, and nutritional deficit. Interventions focused on respiratory monitoring, therapeutic positioning, oxygen therapy, medication collaboration, and nutritional support. The evaluation revealed clinical improvements, including more effective coughing, improved breathing patterns, normalized body temperature, and increased appetite. The results demonstrate that systematic nursing care with a service excellent orientation effectively supports the recovery process in children with pneumonia. This paper aims to contribute to improving the quality of pediatric nursing care, particularly in managing respiratory infections such as pneumonia.

INTEGRATED EMERGENCY RESPONSE SYSTEM BY HEALTH WORKERS AT THE TELUK DALAM COMMUNITY HEALTH CENTER, TELUK DALAM DISTRICT, SOUTH NIAS REGENCY, NORTH SUMATRA PROVINCE, YEAR 2024

Thu, 14 Aug 2025 00:00:00 +0700

The Integrated Emergency Management System (SPGDT) is a government initiative aimed at improving rapid and appropriate emergency services through the integration of healthcare services. However, its implementation in the field often encounters obstacles such as lack of socialization, coordination, and training among healthcare workers, especially at primary healthcare facilities like community health centers (Puskesmas). This study aims to analyze the implementation of the SPGDT by healthcare workers at Teluk Dalam Public Health Center, Teluk Dalam Sub-district, South Nias Regency, North Sumatra Province in 2024, as well as to identify the characteristics of the healthcare workers including age, education, work experience, training, and knowledge level. This research used a descriptive analytic design with a cross-sectional approach. A total of 33 healthcare workers were selected using total sampling. Data were collected using questionnaires and analyzed descriptively using frequency distribution. The majority of respondents held a bachelor's degree (48%), were over 35 years old (61%), had more than 1 year of work experience (79%), had participated in training less than once (55%), and had good or sufficient knowledge (76%) regarding SPGDT. The implementation of SPGDT at Teluk Dalam Public Health Center is supported by healthcare workers who mostly have mature age, sufficient work experience, and adequate knowledge. However, there remains a need to improve training to enhance the effectiveness of the integrated emergency management system.

THE CORRELATION BETWEEN FAMILY SUPPORT SYSTEMS AND ADHERENCE TO ANTENATAL CARE VISITS AT THE UJUNG COMMUNITY HEALTH CENTER, PADANG, UJUNG PADANG DISTRICT, SIMALUNGUN REGENCY, NORTH SUMATRA PROVINCE, IN 2024

Thu, 14 Aug 2025 00:00:00 +0700

Antenatal care (ANC) is one of the most important preventive measures in reducing the risk of pregnancy (AKI) and childbirth (AKB). Pemeriksaan ANC is a range of health services provided to the hamil from the beginning of the hamilan to the end of the persalinan. The purpose of this study is to analyze The Correlation Between Family Dynamics and Parental Adherence to ANC Services at the Ujung Padang Public Health Center, North Sumatra in 2024. The research methodology used is a cross-sectional design, with a population of approximately 30 people per ibu hamil in Puskesmas Ujung Padang. Using the whole sampling technique, the entire population is sampled. Data analysis is carried out using the chi-square analysis revealed a statistically significant association between family dynamics and parental involvement in ANC. With a p-value of 0.001 (p < 0.05) among 30 respondents, the findings indicate that strong family ties are closely linked to increased participation in antenatal care. Because of this, it is recommended that health care providers continue to raise the standard of prenatal care.

APPLICATION OF COUNSELING ON SKILLS AND SELF-EFFICACY IN POSTPARTUM MOTHERS IN PROPOER BREASTFEEDING PRACTICES IN PMB LILI LUSIANA LUSARI

Thu, 14 Aug 2025 00:00:00 +0700

Menyusui adalah proses alami yang memberikan manfaat signifikan bagi pertumbuhan dan perkembangan bayi, baik secara nutrisi, imunologi, maupun psikologis. Namun, praktik menyusui yang tidak tepat masih sering terjadi karena kurangnya pengetahuan, keterampilan, dan rendahnya kepercayaan diri ibu dalam menyusui. Salah satu intervensi yang dapat diterapkan untuk meningkatkan keberhasilan menyusui adalah melalui konseling menyusui. Penelitian ini bertujuan untuk mengetahui pengaruh konseling terhadap keterampilan dan kepercayaan diri ibu pascapersalinan dalam menyusui yang benar. Penelitian ini menggunakan desain kuasi-eksperimental dengan pendekatan pretest-posttest satu kelompok. Sampel penelitian adalah seluruh ibu pascapersalinan yang memenuhi kriteria inklusi di PMB Lili Lusiana Lusari, Kabupaten Serdang Bedagai, Provinsi Sumatera Utara, yang dipilih menggunakan teknik pengambilan sampel total. Intervensi diberikan dalam bentuk konseling menyusui langsung. Data dikumpulkan menggunakan kuesioner Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF) dan lembar observasi keterampilan menyusui. Hasil analisis menunjukkan perbedaan signifikan antara skor sebelum dan sesudah intervensi, yang mengindikasikan peningkatan keterampilan dan kepercayaan diri ibu dalam menyusui. Studi ini menyimpulkan bahwa konseling menyusui efektif dalam meningkatkan keterampilan ibu pascapersalinan dalam praktik menyusui yang benar, dan oleh karena itu direkomendasikan sebagai bagian dari layanan rutin untuk mendukung keberhasilan menyusui.

DETERMINANT FACTORS OF ABORTION OCCURRENCE AMONG PREGNANT WOMEN AT HAJI GENERAL HOSPITAL MEDAN, NORTH SUMATRA PROVINCE, IN 2025

Thu, 14 Aug 2025 00:00:00 +0700

Aborsi merupakan salah satu penyebab utama morbiditas dan mortalitas ibu, khususnya di negara berkembang seperti Indonesia (Kesehatan dkk. 2023). Faktor risiko seperti usia ibu, pendidikan, status ekonomi, riwayat aborsi, dan penyakit penyerta dapat berkontribusi terhadap kejadian aborsi (Dikes Prov.Sumut 2024). Penelitian ini bertujuan untuk mengidentifikasi faktor-faktor penentu yang berhubungan dengan aborsi di kalangan ibu hamil di Rumah Sakit Haji, Kota Medan. Metode: Penelitian ini merupakan studi analitik kuantitatif dengan pendekatan cross-sectional. Sampel terdiri dari seluruh ibu hamil yang mengalami aborsi pada tahun 2024 (Kemenkes RI 2022) sebanyak 50 orang, yang dipilih menggunakan metode total sampling. Data diperoleh dari rekam medis dan dianalisis menggunakan uji Chi-Square. Hasil: Analisis bivariat menunjukkan adanya hubungan yang signifikan antara aborsi dengan usia ibu (p = 0,046), tingkat pendidikan (p = 0,041), status ekonomi (p = 0,041), dan riwayat aborsi sebelumnya (p = 0,034). Namun, tidak ada hubungan signifikan antara riwayat medis dan aborsi (p = 0,684). Kesimpulan: Usia ibu, pendidikan, status ekonomi, dan riwayat aborsi sebelumnya berhubungan secara signifikan dengan aborsi. Sebaliknya, riwayat medis tidak berhubungan secara signifikan. (Fatem Hamama 2019) Disarankan agar penyedia layanan kesehatan meningkatkan skrining dan memberikan edukasi kepada ibu hamil berisiko tinggi untuk mencegah aborsi. (Nurmawan, Siti. Medan 2022)

THE EFFECT OF BABY MASSAGE ON THE QUALITY OF SLEEP IN BABIES IN THE PRACTICE OF MIDWIVES JUWITA MEDAN CITY YEAR 2024

Thu, 14 Aug 2025 00:00:00 +0700

The neonatal mortality rate in Indonesia shows a worrying dynamic, where Maternal Perinatal Death Notification (MPDN) data recorded a surge in infant mortality from 20,882 cases in 2022 to 29,945 cases in 2023. At Juwita's Midwife Practice, Medan Marelan District, Medan City, the practice of baby massage is still little carried out by the community as an effort to improve the quality of sleep of babies in 2016 reaching 143 toddlers. This study was conducted to assess the effect of infant massage on sleep quality in neonates using a pre-experimental design with a single group measured before and after the intervention at the Juwita Midwife Practice, Medan Marelan District, Medan City in 2024. This study falls under the category of experimental research, where the research design is used to identify cause-and-effect relationships through independent variables by the researcher. All babies born at the Juwita Midwife Practice, Medan Marelan District, Medan City were samples in the study. Data shows that during May to June there were 20 pregnant women who gave birth. Based on the results of the calculation, the p value is 0.001<a(0.005). These findings indicate that the alternative hypothesis (Ha) is proven, so it can be concluded that baby massage affects the sleep quality of babies at Juwita Midwife Practice, Medan Marelan District, Medan City. Therefore, healthcare workers are encouraged to regularly integrate baby massage services as an effort to improve babies' sleep quality.

CONTINUITY OF MIDWIFERY CARE FOR MRS. N WITH MILD ANEMIA AT PMB HELEN TARIGAN SP SELAYANG, MEDAN CITY

Thu, 14 Aug 2025 00:00:00 +0700

Anemia adalah kondisi yang ditandai dengan berkurangnya jumlah sel darah merah atau konsentrasi hemoglobin yang lebih rendah dari normal, yang penting untuk mengangkut oksigen ke jaringan tubuh. Gejalanya dapat meliputi kelelahan, lemas, pusing, dan kesulitan bernapas. Kekurangan zat besi adalah penyebab paling umum, tetapi kekurangan folat, vitamin B12, dan vitamin A juga dapat berkontribusi. Anemia sering menyerang anak-anak, remaja putri, wanita yang sedang menstruasi, dan terutama wanita hamil dan pascapersalinan. Menurut Jurnal Keterlibatan Masyarakat dalam Kesehatan , penelitian dari fakultas kedokteran di seluruh Indonesia menunjukkan bahwa kejadian anemia pada ibu hamil di negara ini mencapai 50–63%. Penyebab utama anemia selama kehamilan adalah kekurangan zat besi, yang dipicu oleh faktor-faktor seperti multiparitas, status sosial ekonomi rendah, dan infeksi seperti malaria dan HIV. Selain itu, jarak kelahiran yang tidak teratur juga berkontribusi pada masalah ini. Untuk mengatasi tingginya prevalensi anemia pada ibu hamil, pemerintah telah meluncurkan program Perawatan Antenatal Terpadu. Program ini mencakup layanan konseling bagi ibu hamil untuk membantu mengatasi masalah gizi selama kehamilan. Ibu hamil juga diberikan tablet zat besi (Fe) dan asam folat, minimal 90 tablet selama kehamilan.

CONTINUOUS OBSTETRIC CARE WITH UMBILICAL CORD WRAPPING IN MRS. J AT PMB Bd WANTI S. Keb MEDAN DELI DISTRICT MEDAN CITY NORTH SUMATRA

Thu, 14 Aug 2025 00:00:00 +0700

Tali pusar adalah struktur yang dapat melilit tubuh, bahu, lengan, atau leher bayi. Lilitan tali pusar dapat menyebabkan asfiksia, yang merupakan masalah kritis karena meningkatkan morbiditas dan mortalitas pada bayi baru lahir. Kondisi ini dapat mengganggu aliran darah dan oksigen dari plasenta ke janin, berpotensi mengakibatkan gawat janin, skor Apgar rendah, dan komplikasi neurologis jangka panjang jika tidak dideteksi dan ditangani dengan segera. (Mustar, 2019; Rohmah dkk., 2024) Puntiran tali pusar berulang kali ke satu arah dapat menghambat aliran darah dari ibu ke janin, berpotensi menyebabkan hasil fatal seperti kematian neonatal. Hambatan ini dapat menyebabkan berkurangnya pengiriman oksigen dan nutrisi, yang mengakibatkan keterlambatan pertumbuhan intrauterin, gawat janin, atau bahkan lahir mati jika tidak segera diidentifikasi dan ditangani. (Anggorowati & Widyawati, 2020; Shrestha & Karki, 2024) Studi ini menggunakan pendekatan studi kasus deskriptif yang dilakukan di Praktik Mandiri Bidan Wanti S. Keb di Distrik Medan Deli, Kota Medan, pada tahun 2025. Temuan ini menyoroti pentingnya pengawasan, intervensi tepat waktu, dan penerapan Kontinuitas Perawatan (COC) untuk meningkatkan hasil kesehatan ibu dan bayi baru lahir (Hasanah dkk., 2020; Organisasi, 2024).

MIDWIFERY CARE MANAGEMENT FOR NEWBORN BABY USING LOTUS BIRTH METHOD AT HENNY CLINIC MEDAN LABUHAN DISTRICT IN 2025

Thu, 14 Aug 2025 00:00:00 +0700

Midwifery care for newborns aims to support physiological adaptation, maintain clinical stability, and fulfill basic needs optimally, particularly breastfeeding with colostrum which provides immunological protection and essential nutrients supporting immunity, growth, and development. One natural approach that supports newborn adaptation is the Lotus Birth method, in which the umbilical cord is not cut immediately after birth but allowed to separate naturally, a practice believed to enhance placental blood transfusion, reduce the risk of neonatal anemia, strengthen mother–infant bonding, and support early initiation of breastfeeding. However, the Lotus Birth method remains controversial because inadequate placental care may increase the risk of infection, therefore requiring comprehensive, standardized, and supervised midwifery management. This report aims to describe midwifery care management for a newborn using the Lotus Birth method at Henny Clinic, Medan Labuhan District, in 2025. A descriptive case study was conducted on one normal delivery, with data collected through anamnesis, observation, physical examination, and SOAP documentation, and care implemented using Varney’s seven-step approach. The results showed that the newborn was healthy without complications, with a birth weight of 3000 grams and a body length of 48 centimeters; placental hygiene was maintained, no signs of infection were observed, and the family education.

FACTORS AFFECTING ANXIETY IN EARLY MOBILIZATION AMONG POST-CAESAREAN SECTION MOTHERS AT AEK KANOPAN REGIONAL GENERAL HOSPITAL IN 2024

Thu, 14 Aug 2025 00:00:00 +0700

Caesarean section (CS) is a surgical procedure involving incisions in the abdominal wall and uterus to deliver a baby. The trend of caesarean deliveries has increased globally and nationally, often exceeding the ideal rate recommended by the World Health Organization (WHO). Childbirth is a natural process eagerly awaited by every mother. However, under certain medical conditions, a Caesarean section (CS) becomes the primary option for the safety of both mother and fetus. Globally, the trend of Caesarean section deliveries continues to increase significantly in various parts of the world. The World Health Organization (WHO) notes that the ideal Caesarean section rate should be between 10% and 15%, but in reality, this rate continues to exceed this recommendation. This study aims to determine the factors influencing anxiety in performing early mobilization among post-caesarean section mothers at RSUD Aek Kanopan in 2024. This research utilized a quantitative design with a cross-sectional approach. The sample consisted of 40 post-caesarean section mothers selected using purposive sampling. Data were collected using knowledge questionnaires, the Numeric Rating Scale (NRS) for pain, and the Visual Analog Scale for Anxiety. Data analysis was conducted using univariate and bivariate methods with the Chi-Square test. The analysis revealed that most respondents were aged 20-35 years (73.1%), had a secondary education (78.8%), were employed (55.8%), and were multigravida (35.5%). The majority of respondents lacked family support (73.1%), experienced moderate pain post-operation (57.6%), and had moderate anxiety levels (57.6%). Bivariate analysis showed a significant relationship between family support and pain level with anxiety in performing early mobilization (p = 0.02). Mothers who received family support and experienced mild pain tended to have mild anxiety, while those lacking family support and experiencing severe pain tended to have severe anxiety. These findings highlight the importance of family support and pain management in reducing anxiety and accelerating early mobilization in post-caesarean section mothers.

GERIATRIC NURSING CARE MANAGEMENT WITH A SERVICE EXCELLENCE APPROACH FOR MRS. J WITH GOUT ARTHRITIS AT THE UPTD SOCIAL SERVICES FOR THE ELDERLY, BINAJAI CITY, NORTHSUMATRA PROVINCE, YEAR 2025

Thu, 14 Aug 2025 00:00:00 +0700

Elderly individuals represent a vulnerable group experiencing various functional declines, including an increased risk of degenerative diseases such as Gout Arthritis. This disease is characterized by severe joint pain caused by the accumulation of uric acid crystals, which disrupts daily activities and quality of life. This study aims to implement gerontic nursing care management based on service excellence in the case of Mrs. J, an elderly patient with Gout Arthritis at the UPTD Elderly Social Services Binjai. The research used a descriptive case study method, applying the nursing care process through assessment, diagnosis, planning, implementation, and evaluation. The assessment revealed that Mrs. J experienced acute pain, impaired physical mobility, and sleep disturbances due to inflammation and high uric acid levels (7 mg/dL). Interventions included both pharmacological and non-pharmacological therapies such as massage, education on a low-purine diet, and empathetic communication aligned with the principles of service excellence. The evaluation showed a decrease in pain scale, improvement in sleep quality, and enhanced mobility. This study concludes that implementing gerontic nursing care based on service excellence can improve comfort, independence, and quality of life in elderly patients with Gout Arthritis.