Asuhan Keperawatan pada Pasien Pneumonia dengan Bersihan Jalan Napas Tidak Efektif melalui Penerapan Active Cycle of Breathing Technique (ACBT) di RSUD Haji Surabaya

Latar Belakang: Pneumonia dapat menimbulkan retensi sekret dan masalah Bersihan Jalan Napas Tidak Efektif. Active Cycle of Breathing Technique (ACBT) merupakan latihan pernapasan yang digunakan untuk membantu mobilisasi dan pengeluaran sekret. Tujuan: Menggambarkan asuhan keperawatan pada pasien pneumonia dengan Bersihan Jalan Napas Tidak Efektif melalui penerapan ACBT. Metode: Studi kasus deskriptif pada satu pasien perempuan usia 25 tahun yang dirawat di Ruang Marwah 4 RSUD Haji Surabaya pada 8–10 Juni 2026. ACBT diterapkan dua kali sehari selama tiga hari sesuai protokol yang ditetapkan. Data diperoleh melalui wawancara, pemeriksaan fisik, observasi, dan dokumentasi. Evaluasi meliputi efektivitas batuk, pengeluaran sputum, bunyi napas tambahan, frekuensi napas, keluhan sesak, serta SpO₂ yang dicatat bersama perangkat dan aliran oksigen. Hasil: Pada pengkajian awal pasien mengalami batuk tidak efektif, sputum sulit dikeluarkan, ronki lapang paru kiri bawah, RR 25 kali/menit, dan SpO₂ 94% dengan O₂ nasal kanul 4 L/menit. Pada hari ketiga, batuk menjadi efektif, sputum lebih mudah dikeluarkan dan lebih encer, ronki menjadi minimal, keluhan sesak berkurang, RR 20 kali/menit, dan SpO₂ 99% dengan O₂ nasal kanul 2 L/menit lepas-pasang. Kesimpulan: Dalam konteks asuhan keperawatan dan terapi medis yang berjalan, penerapan ACBT disertai perbaikan indikator bersihan jalan napas pada kasus ini. Temuan studi kasus tidak dapat digunakan untuk menyimpulkan efek kausal ACBT secara mandiri.

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Background: Pneumonia can cause secretion retention and lead to ineffective airway clearance. The Active Cycle of Breathing Technique (ACBT) is a breathing exercise used to facilitate the mobilization and clearance of airway secretions. Objective: To describe nursing care for a patient with pneumonia and ineffective airway clearance through the application of ACBT. Methods: This descriptive case study involved a 25-year-old female patient hospitalized in Marwah 4 Ward, Haji Surabaya Regional General Hospital, from June 8–10, 2026. ACBT was administered twice daily for three days according to the established protocol. Data were collected through interviews, physical examinations, observations, and documentation. The evaluation included cough effectiveness, sputum expectoration, the presence of adventitious breath sounds, respiratory rate, dyspnea complaints, and SpO₂, recorded together with the oxygen delivery device and flow rate. Results: At the initial assessment, the patient presented with an ineffective cough, difficulty expectorating sputum, rhonchi in the left lower lung field, a respiratory rate of 25 breaths/minute, and an SpO₂ of 94% while receiving oxygen via a nasal cannula at 4 L/minute. On the third day, the patient's cough became effective, sputum was easier to expectorate and less viscous, rhonchi were minimal, dyspnea decreased, the respiratory rate improved to 20 breaths/minute, and SpO₂ increased to 99% with intermittent oxygen via a nasal cannula at 2 L/minute. Conclusion: Within the context of ongoing nursing care and medical therapy, the application of ACBT was accompanied by improvements in airway clearance indicators in this case. The findings of this case study cannot be used to establish a causal effect of ACBT independently.