NAMA PASIEN TANGGAL S

Pristianah 9/9/2018 Perut sebah (+), nyeri ulu hati (+)

Kamar A1 tulip 2 PUSING (+) BAB (+) BAK (-) 2 hari
MUAL (+) MUNTAH(+)
RPD : DM

9/10/2018 Perut sebah (+), nyeri ulu hati (+)

BAK (-) 2 hari PUSING (+) BAB (+) BAK (+)
MUAL (+) MUNTAH(-)

9/11/2018

9/12/2018 perut sebah (+) mual(+) nyeri perut (+)

BAB (-) 4 hari

9/13/2018 Keluhan (-)

9/14/2018 Keluhan (-)

 O A
TD : 120/80 Obs. Vomiting Profus
LAB : GDS 150 WBC 6,27 HGB 14,1 PLT 234 Colic Abdomen
BUN 6,2 Creatinin 0,9 DM T2

TD : 120/80 Obs. Vomiting Profus

S : 36 Colic Abdomen
DM T2

TD: 100/80 N=70x/menit Obs. Vomiting Profus

USG : asites Colic Abdomen
Thorax : Efusi Pleura DM T2
Asites
Efusi Fleura

TD : 140/90 N : 77x/M Obs. Vomiting Profus

Colic Abdomen
DM T2
Asites
Efusi Fleura

TD 140/80 Obs. Vomiting Profus

Colic Abdomen
DM T2
Asites
Efusi Fleura
 P
Inf. PZ 14 tpm
Inj. Santagesik 3x1
Inj. Omeprazole 2x1
Inj. Ondancentron 3x8mg
Inj. Mecobalamin 2x1
TERAPI TETAP
Lactulac Syr. 3xc1
PDx : USG
Radiologi

TX tetap

TX Tetap

KRS
PO: ulsafat syp 3xC1
Omeprazole 3x1 caps
codein 3x1 tab
Vivi Chashanti 9/14/2018 demam (+) > 1 mggu TD 100/70
Tulip lt 2 A2 muntah (+) >5x N 86x
mual (+) S 38 C
nyeri ulu hati (+) DL : dbn
S. TF PDx : DL, UL
Infus RL 21 tpm
inj. Ondancentron 3x4mg
inj. Santagesik 3x1
R R Prihatini 9/9/2018 Nyeri pinggang disertai panas 7 hari
Kamar A2 tulip 2 SESAK (-) PUSING (+) BAB (+) BAK (+)
MUAL (+) MUNTAH(+)
RPD : Batu Empedu S

9/10/2018 Nyeri Pinggang (+) Panas (-)

BAK (+) BAB (+) PUSING (+)
Batuk (+)

9/11/2018 LIBUR

9/12/2018 mual (+) nyeri perut (+)

9/13/2018 BAB (-) 6 Hari

9/14/2018 taa
 TD 106/77 Abdomen : NT (+) Colic Abdomen
LAB : WBC 6,86 RBC 3,9 HGB 9,7 PLT 422 TF
GDS; 113 Widal O (-) Widal H (+ 1/160) Anemia
Widal PA (-) Widal PB (-)

TD 110/80 Colic Abdomen

S : 36 TF
Anemia

TD= 110/80 N= 80x/menit Colic Abdomen

USG abdomen tunggu hasil TF
Anemia

TD : 110/70 Colic Abdomen

USG : Cholelitiasis TF
Foto Thorax : TB paru Anemia
Cholelitiasis
TB Paru

TD 110/70 Colic Abdomen

N 80X TF
Anemia
Cholelitiasis
TB Paru
 Inf. PZ 21 TPM
Inj. Ondancentron 3x8mg
Inj. Santagesik 3x1
INJ. Omeprazole 2x1
P/0 Sangobion 1x1
TERAPI TETAP
Injeksi levo floxacin 1x 500
PDX : USG Abdomen + Thorax Foto AP

TX Tetap
USG dibawa kontrol poli

TX tetap
Konsul Paru

TX tetap
Raber paru
Kamar B1 9/13/2018 Badan lemas (+) Pusing (+)
Tn. Sujoto Mual (-) Muntah (-) BAB (+)BAK (+)
RPD : DM (+)

9/14/2018 pusing (+) berkurang

 TD ; 110/70 N:80x/m DM Hiperglikemia Inf. widaKN 2 14 tpm
Abd : BU (+) N Met (-) NT (-) Hipokalemia Inj. Ondancentron 3x4mg
GDS : 310 Vertigo Inj. Santagesic 3x1g
K : 2.5 Inj. Betahistin 3x1
KSR 2x1
Inj. NR 3x6 unit
PDX : EKG, GDA

TD 130/70 DM Hiperglikemia Inf. widaKN 2 14 tpm

N 80X Hipokalemia Inj. Ondancentron 3x4mg
GDS 222 Vertigo Inj. Santagesic 3x1g
Asam urat 10,6 hiperuricemia Inj. NR 3x6 unit
TG 274 dislipidemia po: betahistin 3x1
LDL 170 KSR 3X1
Na 136 Allopurinol 300mg 1x1
K 2,5 Atorvastatin 40mg 0-1-0-0
PDx : GDA , SE
Kamar B2 Tulip 9/12/2018 Perut nyeri (+)
Paulus Parung Mual (+) Muntah (+) 5x
BAB Cair (-)
RPD : DM (-) HT (-)

9/13/2018 Mual(+) Muntah (+) 7x

Nyeri Perut kanan (+)

9/14/2018 nyeri perut bag. Kanan bawah

sampai ke pinggang
 TD ; 120/80 Colic Abdomen Inf. Widabes 14 tpm
N ; 80x/m Vomiting Inj. Antrain 3x1g
Abd ; NT (+) Bilateral Nefhritis Inj. Omeprazole 2x1
USG : Bilateral Nefritis dgn Hidronefrosis d g1 Hidroneprosis D g1 Inj. Ondancentron 3x8mg
NT: (+)
WBC ; 10,97 HGB : 16,3 PLT : 220

TD ; 110 N:80x/m Colic Abdomen TX tetap

Vomiting PDX : BUN, SC, UL, tunggu lab
Bilateral Nefhritis
Hidroneprosis D

TD 120/80 Colic Abdomen Inf. Widabes 14 tpm

N 82x Vomiting Inj. Antrain 3x1g
BUN 19,0 Bilateral Nefhritis Inj. Omeprazole 2x1
SK 1,7 Hidroneprosis D Inj. Ondancentron 3x8mg
Na 137 ISK Inj. Levofloxacin 1x500mg
K 4,6 PDx : BOF
UL : albumin -
eritrosit 2-3
leukosit 1-2
Ny Sumaiyah 9/14/2018 nyeri perut bag. Bawah(+) TD 110/70
Tulip lt 2 B3 mual (+) N 80X
demam (+) WBC 19.14
BAK (+) HB 11,5
sering anyang-anyangan (+) NEUT 81,6%
GDS 162
UL : Alb= -
eritrosit 2-4
leukosit 15-20
ISK + Urosepsis Infus RL 7 tpm
inj. Antrain 3x1
inj. Ranitidin 2x1
in ondancentron 3x8mg
inj ciprofloxacin 2x200g
PDx: USG, DL
Ny. Musni 9/9/2018 Nyeri Ulu Hati (+)
Kamar C1 tulip lt2 SESAK (-) PUSING (-) BAB (+) BAK (+)
MUAL (-) MUNTAH(-)

9/10/2018 Nyeri Ulu Hati (+), Batuk Kering (+)

SESAK (-) PUSING (-) BAB (+) BAK (+)
MUAL (-) MUNTAH(-)

9/11/2018

9/12/2018 Nyeri ulu hati (-)

Sesak (+)

9/13/2018 Sesak berkurang, nyeri (+) BAB (+)

9/14/2018 taa
 TD 108/80 N 80x/m RR 20x/m Colic Abdomen
Abdomen NT (+) Anemia Gravis
LAB : WBC 16,26 HGB : 5,6 PLT : 381 OF
BUN : 20,6 Creatinin : 0,6 GDS 127 ALO
USG : Hepatomegali, Ascites

TD : 110/70 S: 36 Colic Abdomen

Hb= 8.4 Anemia Gravis
Abdomen: Hepatomegali (+) asites(+) OF
Thorax : Efusi Pleura ALO
USG : Hepatomegali, Ascites Efusi Pleura
Asites, Hepatomegali

TD 160/100 Colic Abdomen

N 80x/menit Anemia Gravis
OF
ALO
Efusi Pleura
Asites, Hepatomegali

TD 140/90 Colic Abdomen

N 82X Anemia Gravis
OF
ALO
Efusi Pleura
Asites, Hepatomegali

TD 140/90 Colic Abdomen

N 82X Anemia Gravis
HBsAg(+) OF
anti HCV (-) ALO
Efusi Pleura
Asites, Hepatomegali
HBV (+)
 Inf. Pz 14 tpm
Inj. Antrain 3x1g
Inj. Oncancentron 3x8mg
Inj. Omeprazole 2x1
Inj. Anbacin 2x1
Transfusi PRC 2 Kolf S.D HB > 10

TERAPI TETAP
Nebul Combivent 3 x 1
Konsul Paru

Inf. Pz 14 tpm
Inj. Antrain 3x1g
Inj. Oncancentron 3x8mg
Inj. Omeprazole 2x1
Inj. Anbacin 2x1
Transfusi PRC 2 Kolf S.D HB > 10
Nebul Combivent 3 x 1
pro: pungsi efusi

TX Tetap

tx tetap
Ny. Dalihah 9/12/2018 Nyeri Perut (+) Batuk (+)
Kamar C3 Tulip lt2 BAB (+) BAK (+)
RPD : DM (+) HT (+)

9/13/2018 Batuk dahak (+) Nyeri Perut (+)

TD : 140/90 DM Hiperglikemia
ABD : NT (+) Bronkitis
GDS : 320 Colic Abdomen

TD : 110/70 DM Hiperglikemia
N ; 72x/m Bronkitis
Colic Abdomen
 Inf. RL 14tpm
Inj. Anbacin 2x1
Inj. Omeprazole 2x1
Inj. Santagesic 3x1g
Inj. NR 3x8 unit
Codein 3x10mg
PDX : GDA, USG, EKG

TX tetap
PDX : GDA, Foto Thorax
Kamar e1 9/11/2018 Lemas (+) mual (+) Muntah (-) BAB Hitam (+) 1 hari
Djama'iyah

9/12/2018 BAB Hitam (+) Mual (-) Muntah (-) Lemas (+)
BAK (+)

9/13/2018 Keluhan (-)

TD : 110/70 N : 70x/M Obs. Melena + Anemia
Abd : BU (+) N NT (-)
WBC : 15,65 HGB : 6,4 PLT : 415 GDS : 96
BUN : 8,1 Creatinin : 6,7 N:133
K: 3,9

TD : 110/90 N : 84x/m Obs. Melena + Anemia

TD : 120/80 Obs. Melena + Anemia

Inf. PZ 14 tpm
Inj. Santagesic 3x1 k/p
Inj. Omeprazole 2x40mg
Inj. Ondancentron 3x8mg
Inj. Vit. K 3x1
Inj. Kalnec 3x1
Inj. Ceftriaxone 2x1g
Transfusi PRC 1 Kolf/hari sd HB >10

Tx Tetap

Pro KRS
Kamr D1 9/12/2018 Nyeri dada kiri
Tn. Fatchurrachman Sesak (+) Ngongsro (+)
RPD : HT (+) DAM (+) TB paru sudah pengobatan

9/13/2018 Nyeri dada kiri (+)

Sesak berkurang Ngongsro (+)

9/14/218 Nyeri dada kiri (+)

Sesak berkurang Ngongsro (+)
Sariawan (+)
 TD : 130/90 N: 88X/ M DM Hiperglikemia
WBC : 11,29 HB : 9,9 PLT : 144 Obs. Chest Pain
GDA : 491 NA: 133 Dispepsia
Foto thorax : efusi pleura GF : 68,7%

TD ; 130/90 DM Hiperglikemia
Obs. Chest Pain
Dispepsia
OF
AKI
Hiperlipidemia

TD : 130/80 DM Hiperglikemia
Obs. Chest Pain
Dispepsia
OF
AKI
Hiperlipidemia
Stomatitis
 Inf. PZ 7tpm
Inj. Omeprazole 2x1
Inj. Ondancentron 3x8mg
Inj. Antrain 3x1g K/p
Inj. Ranitidin 2x50mg
ISN 5mg k/p

tx tetap
Kalitex 3x1
Inj. Ca Gluconas 3x1
Inf. D40 + 2 H 3x
Inj. Novomix 2x8umit
PDX : C. Cardio
Profil Lipid

TX tetap
PDX : C. Cardio
Profil Lipid
Nystatin Drop 3xgttII
Ny. Usawatun 9/9/2018 Muntah > 5x sehari, diare (+)
Kamar D3 Tulip lt 2 Badan sumer (+)
Kaki muncul bintik berisi nanah
Maag (+)

9/10/2018 Nyeri Perut (+) Mual (+) Muntah (+) 2x

BAB (-) 6 Hari

9/11/2018

9/12/2018 nyeri perut (+) mual (+)

9/13/2018 Nyeri perut berkurang

Mual (+) Muntah (+)
Badan gatal

9/14/2018 Nyeri perut (-)

Mual (+) Muntah (+)
Badan gatal
BAB (-) 1 hari
 TD : 120/80 N 84x/M Colic Abdomen
LAB : WBC 19.16 HB 13,7 PLT 352 Vomiting Profus
Widal O = 1/80 Widal H 1/160 Suspect HFMD
Widal P AO (-) Widal P BO 1/80 GEADS

TD : 120/80 Colic Abdomen

n : 82x/m Vomiting Profus
Suspect HFMD

TD 120/80 Colic Abdomen

N 80x/menit Vomiting Profus
Ext : Vesikel Eritema Suspect HFMD
GEADS

TD ; 120/90 Colic Abdomen

N; 88x/m Vomiting Profus
36.5 S. Vasculitis
GEADS

TD : 130/90 Colic Abdomen

Vomiting Profus
S. Vasculitis
GEADS
 Inf. Widabes 20 tpm
Inj. Omeprazole 2x40mg
Inj. Ondancentron 3x8mg
Inj. Santagesic 3x1g
Inj. Mecobalamin 2x1
Inj. Ceftriaxone 2x1
Sucralfat syr. 3xC1

Inf. Widabes 20 tpm

Inj. Omeprazole 2x40mg
Inj. Ondancentron 3x8mg
Inj. Santagesic 3x1g
Inj. Ceftriaxone 2x1
Sucralfat syr. 3xC1
konsul : Sp KK

tx tetap
K. Kulit

tx tetap
Diagt 3x1

TX Tetap
Pro USG
Kamar e2 9/12/2018 Mual (+) Muntah (+) S; 36 TD; 110/70
tn . Rachmad Abd ; BU (+)N NT (-)
RPD : DM (-) HT (-)
WBC ; 9,43 HB: 15,3
PLT : 56

9/13/2018 Mual (+) Muntah (+) TD : 110/70 S; 36

NT (+)

Mual (+) Muntah (+) TD : 110/70 S; 36

NT (+)
Obs. Trombositopenia Inf. Widabes 14tpm
S. Dengue Fever Inj. Omeprazole 3x40mg
Low Intake Inj. Ondancentron 3x8mg
Inj. Antrain 3x1
DL Serial

Obs. Trombositopenia TX tetap

S. Dengue Fever PDX : c. Kulit HBSAG,
Low Intake Albumin, HCV, SE
s. SH

Obs. Trombositopenia TX tetap

S. Dengue Fever PDX : c. Kulit HBSAG,
Low Intake Albumin, HCV, SE
s. SH PDX : GDA
Kamar F1 9/11/2018 Nyeri Perut (+) Mual (-) TD : 130/70 S:36
Andika Muntah 5x, BAB >3x cair Abd; BU (+) N. NT (-)
BAK (+) Panas (+) WBC ; 13,93 HGB : 5,9
PLT : 221

9/12/2018 Nyeri Perut (-) Mual (-) TD : 110/70

Muntah (-) BAB (-) BAK (-) S: 36,7
Panas (-)

9/13/2018 Keluhan (-) TD : 110/70

S; 36.5
Colic Abdomen + GEA + Vomiting Inf. RL 20tpm
Inj. Santagesik 3x1
Inj. Ranitidin 2x50mg
Inj. Ondancentron 3x8mg
Inj. Ceftriaxone 2x1gr
Pusilex 2 Tab post BAB

Colic Abdomen + GEA + Vomiting Tx Tetap

PDX : Widal

Colic Abdomen + GEA + Vomiting KRS

Kamar F2 9/12/2018 Panas (+) 5 hari Mual (+) Muntah (+)
Dedy Susanto RPD : DM (-)

13/09.2018 Panas (-) Mual (+) Muntah (+)

13/09.2018 Panas (-) Mual (+) Muntah (+)

TD : 100/70 N : 100x/m Obs. Febris + Trombositopenia Inf. Asering 21tpm
Abd : BU (+)N NT (-) DD DF Inj. Omeprazole 2x40mg
HB : 17,8 WBC : 6.100 Inj. Santagesic 3x1
PLT : 30 Kompres aktif bila demam

TD : 100/70 S: 36,5 Obs. Febris + Trombositopenia Tx tetap

DD DF PDX : DL Serial

TD : 100/70 S: 36,5 Obs. Febris + Trombositopenia Tx tetap

DD DF PDX : DL Serial
Inj. MD 2x125
Kamar G1 9/10/2018 Perut Kembung (+), sesak (-)
Tn. Subandi Mual (-) Muntah (-) Batuk (-)
Mengigigl (+)
RPD : Jantung (+) CKD (+)
HD 1x 2 minggu yang lalu
TD : 130/80
WBC : 7,66 HGB : 11,6
Bun : 74,4 Creatinin : 10,1
Na : 133 K : 5,3 CHL : 99

9/11/2018

9/12/2018 Perut kembung (-), Sesak (-) TD : 120/80

Mual (-) Muntah (-)
BAB (+) BAK (+)

9/13/2018 Keuluhan (-) TD : 110/70

CKD ST V + Uremic Syndrome Inf. Pz 7 tpm
Hiperkalemia Inj. Lasix 3x1
Inj. Omeprazole 2x1
Inj. Ondancentron 3x8mg
Kalitake 3x1

CKD ST V + Uremic Syndrome TX Tetap

Hiperkalemia

CKD ST V + Uremic Syndrome KRS

Hiperkalemia
Tn. Kasan 9/9/2018 Nyeri Perut (+), Sulit Kentut (+)
Kamar G2 BAB (+) Sulit, Nyeri perut sebelah kanan
RPD : HT (+) DM (+)

9/10/2018 Pasien mengatakan tidak ada keluhan

Sunarti 9/11/2018 Nyeri Ulu Hati (+) Mual (+) Muntah (+)
Kamar G2

9/12/2018 Nyeri Ulu Hati (-) Nyeri Pinggang (+) Mual (-)
Muntah (-) BAB (+) BAK (+)

9/13/2018 Keluhan (-)

 TD : 110/70 Colic Abdomen + Dispepsia
Abd : NT (+)
LAB : WBC 14,42 HB 13,3 PLT 378 GDA 194
SGOT 124 SGPTT 169

TD : 120/80 Colic Abdomen + Dispepsia

Abd: BU (+) N , Met (-) Dist (-) DM Hiperglikemia

TD : 120/80 N : 88x/M Dispepsia
WBC : 14,57 RBC : 4,7 HGB : 13,1 PLT :314
GDS : 401 BUN : 4,6 Creatinin : 1,0

TD ;120/70 N: 89x/M DM Hiperglikemia

Dispepsia

TD : 120/70 S : 36 DM Hiperglikemia
Dispepsia
OF
 Inf. RL 20 tpm
Inj. Diphenidramin 3 x 10 mg
Inj. Ondancentron 3 x 8 mg
Curcuma 3x1 tab

Terapi Tetap
Levo 1x 10 p.o
PDX : HBSAg, Antihiv
(Pindah Ruangan)

Inf. Widabes 21 tpm

Inj. Ketoprofen 3x1
Inj. Ondancentron 3x8mg
Inj. Omeprazole 2x40mg
RCL 3x4 Unit (IV)

TX Tetap

TX Tetap
Inj. Levofloxacin 1x500mg
Cek GDA, EKG
NR 3x8unit
Suhermin Dwi 9/9/2018 Kedua tangan kesemutan 1 minggu
Kamar G3 Tulip lt2 Kaki bengkak
RPD : DM (+) HT (+)

9/10/2018 Kaki masih bengkak dan kesemutan

Mual (-) Muntah (-)

9/11/2018

9/12/2018 Kaki masih bengkak dan kesemutan

Mual (-) Muntah (-)

9/13/2018 Keluhan (-)

 TD : 206/105 DMND G.V Inf. PZ 7 tpm
BUN : 80,7 Anemia Inj. Santagesik 3x1
SK : 11,3 HB 7,5 HT Urgency Inj. Lasix 3xII
Amlodipin 0-0-1
Pro Konsul HD

TD : 120/80 DMND G.V Terapi Tetap

N: 84x/M Anemia PDX : USG Abdomen
HT Urgency

TD : 120/80 DMND G.V Terapi Tetap

N: 84x/M Anemia PDX : USG Abdomen, albumin
HT Urgency

TD : 110/70 DMND G.V Tx tetap

N : 83x/m Anemia PDX : Albumin
HT Urgency
Priska Diana 9/9/2018 Sesak (+) kaki bengkak (+)
Kamar H1 tulip lt2 Mual (+) Muntah (+) BAK (-) 2 hari

9/10/2018 Sesak semakin bertambah

akral dingin, sesak (+)

Alfiah 54th 9/10/2018 badan lemas (+)

mual (+) nyeri ulu hati(+)
pusing mbliyur (+)
RPD = DM(+)
RPO = insulin

9/11/2018

9/12/2018 pusing mbliyur (+)

nyeri perut (+)

9/13/2018 Pusing (-) Nyeri Perut (-) Susah tidur

9/14/2018 Taa
 TD : 100/60 Obs. Trombositopenia
Ekstremitas Inf : Edema +/+ CKD
Pulmo :Vesikuler +/+ Rhonki +/+ Hiponatremia
Lab : SK : 3,4 PLT 91 GDS 99 Na 126
PH 91 WBC 42,1 HB 11,7

TD : 200/120 Sepsis
Nadi : Melemah CKD
Bibir : Cyanosis Hiponatremia

TD : 90/60 sepsis+ syok sepsis

Nadi : Melemah CKD
Bibir : Cyanosis hiponatremia
HT urgency

TD 120/80 DM Hiperglikemia
N 82x Hiponatremia
Abdomen= nyeri epigastrium(+) Vertigo
WBC= 19.15 Hiponatremia
HB=12
GDS = 427
Na = 120

TD 110/70 DM Hiperglikemia
Hiponatremia
Vertigo
OF
Hipokalemia

TD :120/80 DM Hiperglikemia
GDA : 431 Hiponatremia
NA : 124 Vertigo
K : 2,9 SGOT : 156 SGPT : 156 OF
Hipokalemia

TD 110/70 DM Hiperglikemia
GDA 355 mg/dl Hiponatremia
Vertigo
OF
Hipokalemia
 Inf. 14 tpm
Inj. Santagesik 3x1g
Inj. Ranitidin 2x50 mg
Inj. Ondancentron 3x8 MG

Pro HCU

vascon mulai 50 nano/menit

meninggal di HCU

inf. Nacl 3% 7 tpm

inj. OMZ 2x1
inj. Diphenhidramin 3x1
inj. Ondancentron 3x8mg
inj. Santagesik 3x1
po: betahistin 3x1
NR 3X10 unit

inf. Nacl 3% 7 tpm

inj. OMZ 2x1
inj. Diphenhidramin 3x1
inj. Ondancentron 3x8mg
inj. Santagesik 3x1
po: betahistin 3x1
NR 3X10 unit

Tx tetap
PDX ; GDA, SE

inf. Nacl 3% 7 tpm

inj. OMZ 2x1
inj. Diphenhidramin 3x1
inj. Ondancentron 3x8mg
 inj. Santagesik 3x1
NR 3X10 unit
po : betahistine 3x1
metformin 3x500mg
PDX: DL, GDA
Tn. Soewedi 9/13/2018 Bab hitam (+) TD 100/70
Tulip lt 2/ H3 lemas (+) N 80X/menit
nyeri perut kiri (+) anemis (+)
Riwayat minum jamu pegel linu Abd= NT (+)
RPD= gastritis HB = 6.8

9/14/2018 Bab hitam (+) 1x TD 130/80

mual (-) N 80x
anemis (+)
Abd= NT (+)
Albumin 3,0
 Melena Inf. PZ 14 tpm
Anemia ec S. gastritis erosiva Inj. Ceftriaxon 2x1 g
Inj. Omeprazole 2x1
Inj. Kalnex 3x1
Inj. Vit K 3x1
po: sucralfat syp 3xC1
Transfusi 2 bag/hari s.d HB >10

Melena tx tetap
Anemia ec S. gastritis erosiva vip albumin 3x1
PDX :
HbsAg, anti HCV
Kamar J1 9/13/2018 Badan Bengkak (+) TD : 180/90
Suharto Mual (+) Muntah (+) WBC :10,59 HB : 8.3
Nyeri dada (+) PLT : 423 GDS : 129
BUN : 100,7 SK : 17,2
 CKD G.V Inf. PZ 7 tpm
Anemia Inj. Omeprazole 2x1
Obs. Chest Pain Inj. Lasix 3x1
Sucralfat syr. 3xc1
PDX : EKG, CKMB, Lipoprotein
Andini 9/9/2018 Panas H-4, Mual (+) Muntah (+)
Kamar K3 Tulip lt2 Diare (+)

10-Sep Pna (-) H-5, Mual (-) Nyeri Perut (-)

Muntah (-) Diare (-)

Suwenda 9/11/2018 nyeri perut (+) mual (+)

BAK (+) sedikit, kuning pekat
RPD HT(+)
RPO amlodipin 10mg

9/12/2018 Nyeri perut (+)

 TD : 100/60 Obs. Febris
S : 37 Colic Abdomen
Lab : WBC 4,52 hb 129 PLT 143 Trombositopenia
GDS 173N 146 K 4.0 GEA
Vomiting

TD : 100 /60 Obs. Febris

Abd : Bu (+)N Met (-) Colic Abdomen
Dist (-) Trombositopenia E.C DF
GEA
Vomiting

TD 120/80 CKD + Dyspepsia

N 80x
Abd : nyeri tekan umbilicus
edema (+) tungkai
WBC = 9.72
HB = 14,5
GDS 100
BUN 29.7
SK 3,7

TD 110/70 CKD + Dyspepsia

 In. Asering 21 tpm
Inj. Omeprazole 2x40 mg
Inj. Ondancentron 3x8mg
Inj. Santagesik 3x1g
Puralex 2 tab tiap diare

KRS

Inf. Pz 7tpm
inj. Ondancentron 3x8mg
inj omeprazole 2x1
inj. Santagesik 3x1
po: sucralfat syp 3xC1

Tx tetap
Sumbangsih 9/10/2018 Mual (+) Nyeri Perut (+) Diare (-)
Kamar L1

9/11/2018 nyeri perut (+)

 TD : 120/80 GERD
Abd : NT (+) GEA
LAB : WBC 5,94 RBC 4,6 HB 13,4 Dispepsia
PLT 309 GS 106 BUN 6,4 Creatin 0,5 Colic abdomen

TD 120/80 GERD
GEA
Dispepsia
Colic abdomen
 Inf. Widabes 21 tpm
Inj. Ondancentron 3x8mg
Inj. Omeprazole 2x40 mg
Inj. Santagesik 3x1
Sucralfat 3xC1
Lotrim F 2x1
Alopuronol 0.5mg 0 -1-1

KRS
Tx pulang: sucralfat 3x CI
Cotrim F 2x1
Allopurinol 2x0,5mg
Indah Ariani / 35 th 9/10/2018 badan lemas post HD
Kamar L2 Tulip lt 2 sesak (+)
RPD = CKD grd V

9/11/2018

9/12/2018 nyeri pada lengan kanan (post HD H-2)

sesak (+)
batuk (+) berdahak

9/13/2018 Tangan kanan masih bengkak

Nyeri (+)Sesak berkurang
 TD 130/90 CKD Grd V+ Uremic Syndr + ALO o2 nasal 4lpm
N 82x RR 28x asma attack inf. Pz 7tpm
Thorax Rh +/+ whe +/+ efusi pleura D in santagesik 3x1
HB 7,5 inj. Lasix 3x1
nebul combivent 3x1
transfusi 1 kolf/hari s.d. hb>8

TD 130/90 CKD Grd V+ Uremic Syndr + ALO pro konsul HD

N 82x RR 28x asma attack o2 nasal 4lpm
Thorax Rh +/+ whe +/+ efusi pleura D inf. Pz 7tpm
HB 8,5 in santagesik 3x1
inj. Lasix 3x1
nebul combivent 3x1

TD : 130/80 CKD Grd V+ Uremic Syndr + ALO Tx tetap

N : 85x/m asma attack Konsul Paru
Ext : edema +/+ efusi pleura D
Pulmo : rh +/+
Kamar J2 Tulip lt 2 9/13/2018 Nyeri Ulu Hati (+) TD : 110/70 N:80x/m
Tulip Kanan Mual (+) Muntah (+) Abd : NT (+)
Tn. Suwarno
Colic Abdomen Inf. Rel 14tpm
Rip Heloral 2x
Inj. Omeprazole 2x1
PDX : USG Abdomen