Asuhan Keperawatan Anak Usia Toddler dengan Masalah Bersihan Jalan Napas Tidak Efektif pada Bronkopneumonia di Rumah Sakit PKU Muhammadiyah Surabaya

Pendahuluan: Bronkopneumonia merupakan proses inflamasi akut pada parenkim paru yang mengenai bronkus dan alveolus, ditandai dengan akumulasi eksudat inflamasi berupa cairan dan sel radang di dalam alveolus. Anak usia toddler memiliki risiko lebih tinggi mengalami hipersekresi mukus disertai ketidakmampuan mengeluarkan sekret secara mandiri akibat belum matangnya refleks batuk, sehingga rentan mengalami masalah keperawatan bersihan jalan napas tidak efektif yang berdampak pada gangguan ventilasi dan oksigenasi.
Tujuan: Mendeskripsikan pelaksanaan asuhan keperawatan secara komprehensif pada anak usia toddler dengan bronkopneumonia yang mengalami bersihan jalan napas tidak efektif, meliputi tahap pengkajian, penegakan diagnosis, perencanaan intervensi, implementasi, hingga evaluasi keperawatan.
Metode: Penelitian ini menggunakan desain deskriptif dengan pendekatan studi kasus. Pengumpulan data dilakukan melalui wawancara, observasi klinis, pemeriksaan fisik, telaah dokumentasi rekam medis, serta hasil pemeriksaan penunjang, dengan asuhan keperawatan mengacu pada SDKI, SIKI, dan SLKI.
Hasil: Kedua pasien mengalami batuk produktif, sekret sulit dikeluarkan, dan ronki pada auskultasi. Intervensi yang diberikan meliputi manajemen jalan napas, pemantauan status respirasi, posisi semi-Fowler, fisioterapi dada, terapi oksigen, pemenuhan cairan, edukasi keluarga, serta kolaborasi pemberian mukolitik dan ekspektoran. Setelah tiga hari perawatan, terjadi penurunan batuk dan sesak napas, sekret lebih mudah dikeluarkan, ronki menghilang, dan saturasi oksigen meningkat menjadi 98–99%.
Kesimpulan: Asuhan keperawatan yang didukung kolaborasi tim kesehatan dan keterlibatan keluarga efektif meningkatkan bersihan jalan napas dan status respirasi pada anak usia toddler dengan bronkopneumonia.
Kata kunci: Bronkopneumonia, anak usia toddler, asuhan keperawatan, bersihan jalan napas tidak efektif, manajemen jalan napas.

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Background: Bronchopneumonia is an acute inflammatory process of the lung parenchyma involving the bronchi and alveoli, characterized by the accumulation of inflammatory exudate consisting of fluid and inflammatory cells within the alveoli. Toddlers are at greater risk of excessive mucus secretion and difficulty clearing airway secretions due to the immaturity of the cough reflex, making them susceptible to the nursing problem of ineffective airway clearance, which can impair ventilation and oxygenation.
Objective: To describe the comprehensive nursing care provided to toddlers with bronchopneumonia experiencing ineffective airway clearance, including assessment, nursing diagnosis, intervention planning, implementation, and evaluation.
Methods: This study employed a descriptive design using a case study approach. Data were collected through interviews, clinical observation, physical examination, review of medical records, and supporting diagnostic examinations. Nursing care was based on the Indonesian Nursing Diagnosis Standards (SDKI), Indonesian Nursing Intervention Standards (SIKI), and Indonesian Nursing Outcome Standards (SLKI).
Results: Both patients presented with a productive cough, difficulty expectorating sputum, and crackles on lung auscultation. Nursing interventions included airway management, respiratory status monitoring, semi-Fowler positioning, chest physiotherapy, oxygen therapy, fluid management, family education, and collaborative administration of mucolytic and expectorant medications. After three days of nursing care, both patients showed clinical improvement, evidenced by reduced cough and dyspnea, easier sputum expectoration, disappearance of crackles, and increased oxygen saturation to 98–99%.
Conclusion: Systematic and continuous nursing care, supported by collaboration among healthcare professionals and family involvement, was effective in improving airway clearance and respiratory status in toddlers with bronchopneumonia.
Keywords: Bronchopneumonia, toddler, nursing care, ineffective airway clearance, airway management.