Tujuan Pengukuran CVP
Pengukuran CVP bertujuan untuk mengetahui nilai tekanan dari vena cava dan atrium kanan.
Manfaat Nilai CVP
- Mengetahui hemodinamik pasien.
- Memandu dalam pemberian terapi cairan.
Nilai Normal CVP : 5-8 cmH2O
Faktor – Faktor yang Mempengaruhi nilai CVP
- Keadaan yang membuat nilai CVP meningkat: Penyakit seperti tamponade jantung, sesak nafas berat, emboli paru, efusi pleura, hipertensi paru, tension pneumothoraks, penurunan curah jantung, gagal jantung, hipervolemia, penggunaan ventilator.
- Keadaan yang membuat nilai CVP menurun; inspirasi dalam , hipovolemia, syok distributif.
Langkah – Langkah Pengukuran CVP
Persiapan Alat
- Infus set serta cairan NaCl 0,9%
- Treeway
- Ruler
- Medifix line
- Standar Infus
Pre Interaksi
- Identifikasi pasien menggunakan minimal dua identitas (nama lengkap, tanggal lahir, dan/atau nomor rekam medis)
- Memberikan salam serta jelaskan tujuan dan prosedur tindakan
- Memberikan kesempatan kepada pasien untuk bertanya.
- Jaga privasi pasien.
Tahap Kerja
- Cuci tangan
- Memakai APD; handscoen, masker medis.
- Posisikan pasien tidur telentang (datar)
- Ukur titik nol (zero point); titik tersebut berada di interkosta ke 4 sejajar dengan garis midaksila pasien.
- Alirkan cairan NaCl 0,9% tadi sampai batas ruler mencapai 20-25 cm
- Tutup aliran treeway dari arah infus Nacl 0,9%, sehingga treeway yang terbuka merupakan arah dari ruler ke pasien.
- Amati fluktuasi penurunan cairan yang berada di ruler, biarkan sampai stabil.
- Setelah cairan stabil, maka itulah ukuran CVP pasien.
- Catat nilai CVP dalam dokumentasi keperawatan.
Tahap Terminasi
- Jelaskan kepada pasien bahwa tindakan telah selesai
- Beri tahu pasien hasil pengukuran CVP.
- Lakukan kontrak waktu untuk pengukuran selanjutnya.
- Pamit kepada pasien.
Note:
Posisi pasien saat pengukuran CVP adalah supine / datar. Pada kondisi kondisi tertentu mungkin saja pasien tidak dapat diposisikan supine, sehingga pasien hanya posisi semi fowler. Bila saat pengukuran pertama semi fowler maka pengukuran selanjutnya sebaiknya juga semi fowler agar terjaga kesamaan dan akurasi pengukuran nya. Atau bila posisi pasien kerap berbeda, maka lakukan selalu
Pasien dengan ventilasi mekanis yang di berikan PEEP akan mempengaruhi tekanan vena pasien, oleh karena itu tanyakan pada dokter KIC apakah hasil pengukuran CVP akan dikurangi PEEP pasien atau tidak.
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Djalil, N. K. D., Sjattar, E. L. S., & Syahrul, S. (2020). Pengaruh PEEP Terhadap CVP pada Pasien yang terpasang Ventillator Mekanik : Literatur Review. Jurnal Keperawatan Muhammadiyah, 5(2). https://doi.org/http://dx.doi.org/10.30651/jkm.v5i2.4816
Mubarak, J., Lubis, E., & Dewi, N. A. (2021). Pengaruh Perubahan Posisi terhadap Hasil Ukur Tekanan Vena Sentral pada Pasien Critical Care di Gedung A RSUPN Dr. Cipto Mangunkusumo. Jurnal Ilmu Kesehatan Dharmas Indonesia (JIKDI), 1(1), 1–5. https://ejournal.undhari.ac.id/index.php/jikdi/article/view/210
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