Analisis Asuhan Keperawatan Pada TN. I Dengan Gangguan Sistem Pernapasan Akibat Tuberkulosis Paru Dengan Penerapan Intervensi Kombinasi Fisioterapi Dada Dan Kolaborasi Pemasangan Ventilator Terhadap Bersihan Jalan Napas Tidak Efektif Di Ruang Intensive Care Unit (ICU) RSUD Cililin Bandung Barat Tahun 2026

Abstract

Background : Tuberculosis (TB) is an infection of the lower respiratory tract caused by the bacterium Mycobacterium tuberculosis. Transmission most often occurs when a person inhales droplets from a TB sufferer, allowing the bacteria to enter and settle in the bronchioles or alveoli. Besides airborne transmission, TB bacteria can also enter the body through the digestive tract if a person consumes contaminated, unpasteurized milk, or in certain cases through skin wounds. Objective : To analyze nursing care for patients with respiratory disorders due to pulmonary tuberculosis, using chest physiotherapy interventions and collaborative ventilator placement for ineffective airway clearance in the intensive care unit (ICU) of Cililin Regional Hospital. Method : The method used was descriptive analytic with a case study approach on one client in the ICU of Cililin Regional Hospital in 2026. Data collection was conducted through interviews, observation, physical examination, documentation study, and literature review. Data were analyzed using a nursing approach process that includes assessment, diagnosis, implementation, and evaluation. Results : the results of the assessment showed that the patient had a cough for 1 week SMRS dry cough SMRS, cough with phlegm after being admitted to the hospital, fever for 1 week the patient had been given warm compresses at home but the fever did not go down, excessive sweating, since being admitted to the hospital fever 39 C, difficulty breathing, fatigue, weight loss from 54 kg to 48 kg, thick white sputum, accompanied by chest pain, currently the client is positioned in high fowler with oxygen therapy of 15 lpm using a Non Rebreathing Mask (NRM) and the patient is getting collaboration with ventilator administration and additional wheezing and rhonchi sounds are heard. The family also said that the client has no appetite and there is weight loss accompanied by fever at night, currently the client is conscious GCS E: 4 V: 5 M: 6 (Compos Mentis). The client looks weak, lethargic, pale just lying in bed and has a urinary catheter installed. Conclusion : This case study demonstrates the effectiveness of comprehensive nursing care, combining chest physiotherapy and ventilator placement, in addressing ineffective airway clearance in patients with pulmonary tuberculosis (TB).