Community Nursing on

Adolescence
.
 Adolescence
• Transitional period of
childhood to adulthood
According to WHO
adolescence is ranging
between 12 to 24 y.o., married
is not included.

• Stage of life which is identified

by its change in:
1. Physical anatomy
2. Behavior
3. Cognitive
4. Biological needs
5. Emotional
 Adolescence Phase
• Early adolescence (11-14 y.o)
 Change of primary puberty & its responses
• Middle adolescence (15-17 y.o)
 Transition of orientation where those are
more dominant than others
• Late adolescence (18-20 y.o)
 Transition of adult, where they starting to
look for suitable jobs
(Crockett and Peterson, 1993)
 Physical Transition
• Weight
• Height
female, approx. at 17-18 y.o
male, approx. at 19-20 y.o
• Body Proportion
• Internal Organs
• Sexual Organs
maximum size reached, but still yet mature up ‘till late
adolescence.
 Transitional characteristics
Female Male
•Breast develops •Growth of testical
•Pubic hair grows •Pubic hair
•Body gowth • Body growth
•Menarche • Transitional of penis, prostatic
•Axillar hair glands
• First ejaculation
•Beard, mustache, hairy face
•Axilla hair
 Piaget’s Cognitive Transition
1. Abstract
Using ideas and critical thinking in solving
problems
2. Idealistic
Ideally think of their selves, others also their
social everyday
3. Logic
analyzing method taken after their critical
thinking trial
 Consider these
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 Emotional changes
The main differences between this community
and the younger identified in its type of
stimulus and its level of quality.

Findings: anger, fear, jealousy, curiosity,

sadness & happiness expression, passion and
compassion expression.
 Psychosocial Findings (Ericsson)
• Identity vs Role
developmental task: to be independent with
his/her own identity
• Problems:
Moody
Decision making
Identity taking
 Havighurst’s Psychosocial tasks
1. Adapting changes physically &
psychologically.
2. Learning in socializing as men or women
3. Having their emotional independency
4. To be good and responsible citizen
5. Having their independency and certainty in
economic status

www.education.com
 Grouping
1. Close friends : 2-3, same sex, same in interest
2. Small group : consist of 2 groups, possibly heterosex
3. Large group : some groups, low intersocial
interaction
4. Organized group : made by formal consideration
5. Gang : rejection by antisocial attempt group
 Acceptance and Rejection in Group
criterias
1. First impression
2. Reputation
3. Performance suitability
4. Social behavior, which identified by
cooperation, responsibility, mindful, wisdom,
5. Emotional maturity
 Interests
• Social interest
• Educational interest
• Religion and worship interest
• Sexual interest
 Social interest
• Vacation
• Party
• Curiosity to new items
(drugs, sexual activity,
alcoholism)
• Problem sharing
• Helping others
• Critics
• Surrounding
consideration
 Educational interest
Affected by means of workfields

Religion interest
Exploring religion as an emotional and intellectual
impulse

Sexual interest
As an improvement in sexual needs they start to
gather more information from sources elsewhere
 Problems
Because of their interest improvement, somehow
it may brings problems, especially their wellbeing
• Developmental
• Nutritional
• Reproduction
• STD & HIV/AIDS
• Drugs and alcoholism
• Sexual harassment, adultery, pornography, etc.
 Expanding Nurse’s Role
• Assessing
• Diagnosing
• Planning
• Implementing
• Evaluating
 Assessing teenagers
• Age
• Education status
• Social/extra campus activity
• Health problem finding (past and present
illness)
• Spare time activity
• Local habit
 Planning
1. Health Promotion
2. Health Prevention
3. Curative level
4. Rehabilitative level
 Implementing
1. Not to be in formal terms
2. Not in teaching performance
3. Give them the real evidence
 Evaluating
• Cognitive
• Affective
• Psychomotor
through…
• Structure
• Process
• Output/outcome
 P4GN
Pencegahan Penanggulangan Penyalahgunaan dan Peredaran Gelap
Narkoba
• Tujuan :
Membentuk masyarakat/organisasi yg kompeten dalam berpartisipasi
mengenali keberadaan dan dampak napza
• Komponen :
Tokoh masyarakat, pemuda (kartar), PKK, Tenaga kesehatan (perawat
komunitas), LSM-LSM dan BNP.
• Kegiatan :
1. Demand Reduction (Preventif, Kuratif, Rehabilitatif)
2. Supply Control (Pengawasan, Pemberantasan, Harm Reduction)
 Kegiatan P4GN
1. Meningkatkan pengetahuan masyarakat tentang napza
dan bahayanya.
2. Meningkatkan komitmen dan kerja sama lintas sektor.
3. Meningkatkan keamanan lingkungan, pengawasan
untuk tidak memberi ruang gerak bagi para pengedar
napza.
4. Membangun sistem pelaporan, informasi, tentang
masalah napza di lingkungan masing-masing dengan
tenaga kesehatan dan aparat penegak hukum.
5. Meningkatkan kegiatan agama dan kegiatan yang
positif di lingkungan masing-masing.
Asuhan Keperawatan Komunitas

PERAN PERAWAT

PERAN KLIEN
 Pengkajian
SUMBER DATA
KOMPONEN
INDIVIDU KOMUNITAS
Semua indra Windshield survey
Observasi/ Otoskop
Inspeksi Optalmoskop
Stetoskop Windshield survey
Auskultasi
Termometer Status kesehatan, data
Tanda-tanda Tensimeter demografi, angka kelahiran,
Vital angka kematian
Sistem kardiovaskuler, Observasi sistem sosial
respirasi dll pendidikan, ekonomi,
Review Sistem Head to toe komunikasi, transportasi

Tes darah, sinar X, CT scan Data sensus, data survei,

kepustakaan, pusat penelitian
Laboratorium kesehatan dan masyarakat
 Diagnosa
P E S
Tingkat Karakteristik
Individu Individu

NANDA
Tingkat 5 tugas keluarga di
Tanda /
Keluarga bidang kesehatan
Gejala /
Data
Deskripsi masalah, Karakteristik
Tingkat respon/keadaan masyarakat
Komunitas (Ketidakmampuan
masy…)
PERENCANAAN
• Menentukan prioritas
• Menentukan kriteria hasil
• Menentukan rencana tindakan
• Implementasi
• Dokumentasi

Perencanaan pada askep klien di komunitas :

empowerment, negotiation dan networking
 HIRARKI KOMUNITAS
HIRARKI MASLOW
Aktualisasi Aktualisasi
diri komunitas

Harga diri Kebanggaan

komunitas

Kasih sayang dan

Pendidikan
rasa memiliki
Partisipasi

Aman Keamanan, perlindungan

Fisiologis Aktivitas yang mendukung

kehidupan

Perbandingan kebutuhan dasar individu dengan komunitas sebagai klien

(Higgs&Gustafson, 1995)
28
 PELAKSANAAN & EVALUASI
• Proses evaluasi :
» KOGNITIF
» AFEKTIF
» PSIKOMOTOR
» PERUBAHAN FUNGSI
» KEMANDIRIAN
» EMPOWERING, NETWORKING, NEGOTIATION
» DATA YANG TERKUMPUL : TUJUAN DAN
PENCAPAIAN TUJUAN
 HAL-HAL YANG MEMPENGARUHI
PENETAPAN PRIORITAS MASALAH

• Ancaman kehidupan & kesehatan

• Sumber daya dan dana yang tersedia
• Peran serta klien
• Prinsip ilmiah dalam praktik keperawatan
• Hirarkhi “Maslow’s” dan “Komunitas”
 PERAWAT KOMUNITAS
ASUHAN KEPERAWATAN PASIEN (PRIORITAS) KONTAK
PUSKESMAS
PENGKAJIAN KEPERAWATAN
PASIEN  DETEKSI DINI (SASARAN PRIORITAS)

PENYULUHAN KESEHATAN • POLIKLINIK PUSKESMAS,

• PUSTU,
TINDAKAN KEPERAWATAN • PUSLING, POSYANDU,
(DIRECT CARE) • POS KES DESA

KONSELING KEPERAWATAN

PENGOBATAN
(SESUAI KEWENANGAN)
RUJUKAN PASIEN/MASALAH KES
DOKUMENTASI KEPERAWATAN
 PERAWAT KOMUNITAS
KUNJUNGAN RUMAH OLEH PERAWAT (HOME VISIT
/HOME CARE) TERENCANA PEMBINAAN KELUARGA
PENGKAJIAN KEPERAWATAN ANGGOTA
KELUARGA LAIN  DETEKSI DINI
KASUS/MASALAH KONTAK SERUMAH
KELUARGA
PENDIDIKAN/ PENYULUHAN KESEHATAN/ RAWAN KES
KEPERAWATAN TERENCANA DI KELUARGA
PRIORITAS
TINDAKAN KEPERAWATAN (DIRECT CARE)
PENDERITA KELUARGA
PEMANTAUAN KETERATURAN PENGOBATAN D/ KASUS
PENGENDALIAN INFEKSI DI KELUARGA
TLP
KONSELING KEPERAWATAN/KESEHATAN

DOKUMENTASI KEPERAWATAN