Hipertensi Pada Kehamilan Powerpoint For Mac
PERTOLONGAN PERTAMA PADA PERDARAHAN KEHAMILAN, EKLAMSIA, DAN PERDARAHAN POST PARTUM KELOMPOK 5 ALLPPT.com _ Free PowerPoint Templates, Diagrams and Charts DEFINISI Perdarahan yang berhubungan dengan persalinan dib edakan dalam dua kelompok utama yaitu perdarahan antepartum dan perdarahan postpartum. Pada penderita dengan hipertensi kronis didapatkan tekanan darah >140/90 mmHg sebelum hamil atau sebelum usia kehamilan 20-21 minggu. Nadi: dihitung 15 menit dikalikan empat, menghitung dengannadi pada pergelangan tangannya.
. Esmaeil Shokri 2015-03-01 Full Text Available Background: There are various factors that may cause pain and dysfunction in the pelvic region. Myofascial trigger points can likewise contribute in pelvic pain. Common treatments for myofascial trigger points include electrotherapy, laser therapy, massage, ischemic compression, dry-needling, stretch, icing, heating, and biofeedback. Case Report: A 26 year old man with an exertion-related pain that lasted 5 months was referred for physiotherapy consultation.
He had no pain at rest but reported a referral pain from perineal region to the anus and muscular stiffness following a bout of physical activity. On palpation there was a trigger point in the perineal region with referral pain to anus.
At the beginning of the treatment, the patient was asked to stop his physical activities. The patient received a treatment package which was useful in the management of trigger points. After 7 sessions of treatment the pain was diminished and there was no exercise induced stiffness. The patient was followed for 10 months later and no pain and stiffness was reported. Conclusion: The application of heat, friction massage, stretching, combined with endurance exercise could be an effective treatment for reliving the pain and muscular stiffness caused by trigger points. Jyothirmai 2015-10-01 Full Text Available Background: Upper trapezius trigger points is a common cause for neck pain, decreased cervical range of motion and functional activities. The purpose of the study was to evaluate the effectiveness of integrated neuromuscular inhibitory technique (INIT along with specific strength training exercises in reducing pain, improving ROM and functional activities in subjects with upper trapezius trigger point.
Methods: Thirty subjects were diagnosed with upper trapezius trigger points were included in the study. These patients were randomly allocated to intervention group (n=15, which underwent a 4- weeks training program of INIT along with specific strength training & control group (n=15 that received INIT alone. The outcome measures were taken before and after treatment. Outcomes were measured by visual analogue scale, cervical range of motion and neck disability index. Within the groups VAS, NDI, and cervical lateral flexion and rotation showed significant change in the mean value.
The comparison of pre and post VAS in experimental group and control group showed a significant change in the experimental group.Paired sample t- test was used to analyze changes from before and after intervention programmed. Results: There is a statistically significant (p. Wesley Smith Level-1 Trigger Hardware and Software The trigger synchronization procedures for running with cosmic muons and operating with the LHC were reviewed during the May electronics week.
Firmware maintenance issues were also reviewed. Link tests between the new ECAL endcap trigger concentrator cards (TCC48) and the Regional Calorimeter Trigger have been performed. Firmware for the energy sum triggers and an upgraded tau trigger of the Global Calorimeter Triggers has been developed and is under test. The optical fiber receiver boards for the Track-Finder trigger theta links of the DT chambers are now all installed.
The RPC trigger is being made more robust by additional chamber and cable shielding and also by firmware upgrades. For the CSC’s the front-end and trigger motherboard firmware have been updated. New RPC patterns and DT/CSC lookup tables taking into account phi asymmetries in the magnetic field configuration are under study. The motherboard for the new pipeline synchronizer of the Global Trigg.
Smith 2012-01-01 Level-1 Trigger The Level-1 Trigger group is ready to deploy improvements to the L1 Trigger algorithms for 2012. These include new high-PT patterns for the RPC endcap, an improved CSC PT assignment, a new PT-matching algorithm for the Global Muon Trigger, and new calibrations for ECAL, HCAL, and the Regional Calorimeter Trigger. These should improve the efficiency, rate, and stability of the L1 Trigger. The L1 Trigger group also is migrating the online systems to SLC5. To make the data transfer from the Global Calorimeter Trigger to the Global Trigger more reliable and also to allow checking the data integrity online, a new optical link system has been developed by the GCT and GT groups and successfully tested at the CMS electronics integration facility in building 904. This new system is now undergoing further tests at Point 5 before being deployed for data-taking this year. New L1 trigger menus have recently been studied and proposed by Emmanuelle Perez and the L1 Detector Performance Group.
Smith At the March meeting, the CMS trigger group reported on progress in production, tests in the Electronics Integration Center (EIC) in Prevessin 904, progress on trigger installation in the underground counting room at point 5, USC55, the program of trigger pattern tests and vertical slice tests and planning for the Global Runs starting this summer. The trigger group is engaged in the final stages of production testing, systems integration, and software and firmware development. Most systems are delivering final tested electronics to CERN. The installation in USC55 is underway and integration testing is in full swing.
A program of orderly connection and checkout with subsystems and central systems has been developed. This program includes a series of vertical subsystem slice tests providing validation of a portion of each subsystem from front-end electronics through the trigger and DAQ to data captured and stored.
After full checkout, trigger subsystems will be then operated in the CMS Global Runs. Wesley Smith Level-1 Trigger Hardware and Software The production of the trigger hardware is now basically finished, and in time for the turn-on of the LHC. The last boards produced are the Trigger Concentrator Cards for the ECAL Endcaps (TCC-EE). After the recent installation of the four EE Dees, the TCC-EE prototypes were used for their commissioning. Production boards are arriving and are being tested continuously, with the last ones expected in November. The Regional Calorimeter Trigger hardware is fully integrated after installation of the last EE cables.
Pattern tests from the HCAL up to the GCT have been performed successfully. The HCAL triggers are fully operational, including the connection of the HCAL-outer and forward-HCAL (HO/HF) technical triggers to the Global Trigger. The HCAL Trigger and Readout (HTR) board firmware has been updated to permit recording of the tower “feature bit” in the data. The Global Calorimeter Trigger hardware is installed, but some firmware developments are still n.
by Wesley Smith 2010-01-01 Level-1 Trigger Hardware and Software The overall status of the L1 trigger has been excellent and the running efficiency has been high during physics fills. The timing is good to about 1%. The fine-tuning of the time synchronization of muon triggers is ongoing and will be completed after more than 10 nb-1 of data have been recorded. The CSC trigger primitive and RPC trigger timing have been refined. A new configuration for the CSC Track Finder featured modified beam halo cuts and improved ghost cancellation logic. More direct control was provided for the DT opto-receivers.
New RPC Cosmic Trigger (RBC/TTU) trigger algorithms were enabled for collision runs. There is further work planned during the next technical stop to investigate a few of the links from the ECAL to the Regional Calorimeter Trigger (RCT). New firmware and a new configuration to handle trigger rate spikes in the ECAL barrel are also being tested. A board newly developed by the tracker group (ReTRI) has been installed and activated to block re. Smith 2010-01-01 Level-1 Trigger Hardware and Software The Level-1 Trigger hardware has performed well during both the recent proton-proton and heavy ion running. Efforts were made to improve the visibility and handling of alarms and warnings.
The tracker ReTRI boards that prevent fixed frequencies of Level-1 Triggers are now configured through the Trigger Supervisor. The Global Calorimeter Trigger (GCT) team has introduced a buffer cleanup procedure at stops and a reset of the QPLL during configuring to ensure recalibration in case of a switch from the LHC clock to the local clock. A device to test the cables between the Regional Calorimeter Trigger and the GCT has been manufactured. A wrong charge bit was fixed in the CSC Trigger. The ECAL group is improving crystal masking and spike suppression in the trigger primitives.
New firmware for the Drift Tube Track Finder (DTTF) sorters was developed to improve fake track tagging and sorting. Zero suppression was implemented in the DT Sector Collector readout. The track finder b. Wesley Smith Trigger Hardware The status of the trigger components was presented during the September CMS Week and Annual Review and at the monthly trigger meetings in October and November. Procedures for cold and warm starts (e.g. Refreshing of trigger parameters stored in registers) of the trigger subsystems have been studied. Reviews of parts of the Global Calorimeter Trigger (GCT) and the Global Trigger (GT) have taken place in October and November.
The CERN group summarized the status of the Trigger Timing and Control (TTC) system. All TTC crates and boards are installed in the underground counting room, USC55. The central clock system will be upgraded in December (after the Global Run at the end of November GREN) to the new RF2TTC LHC machine interface timing module. Migration of subsystem's TTC PCs to SLC4/ XDAQ 3.12 is being prepared. Work is on going to unify the access to Local Timing Control (LTC) and TTC CMS interface module (TTCci) via SOAP (Simple Object Access Protocol, a lightweight XML-based messaging.
Smith from contributions of C. Leonidopoulos 2010-01-01 Level-1 Trigger Hardware and Software Since nearly all of the Level-1 (L1) Trigger hardware at Point 5 has been commissioned, activities during the past months focused on the fine-tuning of synchronization, particularly for the ECAL and the CSC systems, on firmware upgrades and on improving trigger operation and monitoring. Periodic resynchronizations or hard resets and a shortened luminosity section interval of 23 seconds were implemented. For the DT sector collectors, an automatic power-off was installed in case of high temperatures, and the monitoring capabilities of the opto-receivers and the mini-crates were enhanced. The DTTF and the CSCTF now have improved memory lookup tables. The HCAL trigger primitive logic implemented a new algorithm providing better stability of the energy measurement in the presence of any phase misalignment.
For the Global Calorimeter Trigger, additional Source Cards have been manufactured and tested. Testing of the new tau, missing ET and missing HT algorithms is underw. Wesley Smith Level-1 Trigger Hardware and Software The final parts of the Level-1 trigger hardware are now being put in place. For the ECAL endcaps, more than half of the Trigger Concentrator Cards for the ECAL Endcap (TCC-EE) are now available at CERN, such that one complete endcap can be covered. The Global Trigger now correctly handles ECAL calibration sequences, without being influenced by backpressure. The Regional Calorimeter Trigger (RCT) hardware is complete and working in USC55.
Intra-crate tests of all 18 RCT crates and the Global Calorimeter Trigger (GCT) are regularly taking place. Pattern tests have successfully captured data from HCAL through RCT to the GCT Source Cards.
HB/HE trigger data are being compared with emulator results to track down the very few remaining hardware problems. The treatment of hot and dead cells, including their recording in the database, has been defined. For the GCT, excellent agreement between the emulator and data has been achieved for jets and HF ET sums. There is still som. Smith Level-1 Trigger Hardware and Software The trigger system has been constantly in use in cosmic and commissioning data taking periods. During CRAFT running it delivered 300 million muon and calorimeter triggers to CMS.
It has performed stably and reliably. During the abort gaps it has also provided laser and other calibration triggers. Timing issues, namely synchronization and latency issues, have been solved. About half of the Trigger Concentrator Cards for the ECAL Endcap (TCC-EE) are installed, and the firmware is being worked on. The production of the other half has started. The HCAL Trigger and Readout (HTR) card firmware has been updated, and new features such as fast parallel zero-suppression have been included. Repairs of drift tube (DT) trigger mini-crates, optical links and receivers of sector collectors are under way and have been completed on YB0.
New firmware for the optical receivers of the theta links to the drift tube track finder is being installed. In parallel, tests with new eta track finde. Carlin with contributions from D. Acosta 2012-01-01 Level-1 Trigger Data-taking continues at cruising speed, with high availability of all components of the Level-1 trigger. We have operated the trigger up to a luminosity of 7.6E33, where we approached 100 kHz using the 7E33 prescale column.
Recently, the pause without triggers in case of an automatic 'RESYNC' signal (the 'settle' and 'recover' time) was reduced in order to minimise the overall dead-time. This may become very important when the LHC comes back with higher energy and luminosity after LS1.
We are also preparing for data-taking in the proton-lead run in early 2013. The CASTOR detector will make its comeback into CMS and triggering capabilities are being prepared for this.
Steps to be taken include improved cooperation with the TOTEM trigger system and using the LHC clock during the injection and ramp phases of LHC. Studies are being finalised that will have a bearing on the Trigger Technical Design Report (TDR), which is to be rea. Smith At the December meeting, the CMS trigger group reported on progress in production, tests in the Electronics Integration Center (EIC) in Prevessin 904, progress on trigger installation in the underground counting room at point 5, USC55, and results from the Magnet Test and Cosmic Challenge (MTCC) phase II. The trigger group is engaged in the final stages of production testing, systems integration, and software and firmware development. Most systems are delivering final tested electronics to CERN. The installation in USC55 is underway and moving towards integration testing. A program of orderly connection and checkout with subsystems and central systems has been developed.
This program includes a series of vertical subsystem slice tests providing validation of a portion of each subsystem from front-end electronics through the trigger and DAQ to data captured and stored. This is combined with operations and testing without beam that will continue until startup. The plans for start-up, pilot and early running tri. Wesley Smith 2011-01-01 Level-1 Trigger Hardware and Software New Forward Scintillating Counters (FSC) for rapidity gap measurements have been installed and integrated into the Trigger recently. For the Global Muon Trigger, tuning of quality criteria has led to improvements in muon trigger efficiencies. Several subsystems have started campaigns to increase spares by recovering boards or producing new ones.
The barrel muon sector collector test system has been reactivated, new η track finder boards are in production, and φ track finder boards are under revision. In the CSC track finder, an η asymmetry problem has been corrected. New pT look-up tables have also improved efficiency. RPC patterns were changed from four out of six coincident layers to three out of six in the barrel, which led to a significant increase in efficiency.
A new PAC firmware to trigger on heavy stable charged particles allows looking for chamber hit coincidences in two consecutive bunch-crossings. The redesign of the L1 Trigger Emulator. Smith, from contributions of D. Acosta 2012-01-01 The L1 Trigger group deployed several major improvements this year. Compared to 2011, the single-muon trigger rate has been reduced by a factor of 2 and the η coverage has been restored to 2.4, with high efficiency.
During the current technical stop, a higher jet seed threshold will be applied in the Global Calorimeter Trigger in order to significantly reduce the strong pile-up dependence of the HT and multi-jet triggers. The currently deployed L1 menu, with the “6E33” prescales, has a total rate of less than 100 kHz and operates with detector readout dead time of less than 3% for luminosities up to 6.5 × 1033 cm–2s–1. Further prescale sets have been created for 7 and 8 × 1033 cm–2s–1 luminosities. The L1 DPG is evaluating the performance of the Trigger for upcoming conferences and publication. Progress on the Trigger upgrade was reviewed during the May Upgrade Week. We are investigating scenarios for stagin.
Smith from contributions of C. Leonidopoulos, I. Varela and C. Level-1 Trigger Hardware and Software Over the past few months, the Level-1 trigger has successfully recorded data with cosmic rays over long continuous stretches as well as LHC splash events, beam halo, and collision events. The L1 trigger hardware, firmware, synchronization, performance and readiness for beam operation were reviewed in October. All L1 trigger hardware is now installed at Point 5, and most of it is completely commissioned. While the barrel ECAL Trigger Concentrator Cards are fully operational, the recently delivered endcap ECAL TCC system is still being commissioned.
Hipertensi Pada Kehamilan Powerpoint For Macam2
For most systems there is a sufficient number of spares available, but for a few systems additional reserve modules are needed. It was decided to increase the overall L1 latency by three bunch crossings to increase the safety margin for trigger timing adjustments. In order for CMS to continue data taking during LHC frequency ramps, the clock distribution tree needs to be reset. The procedures for this have been tested. Arcidiacono 2013-01-01 In 2013 the Trigger Studies Group (TSG) has been restructured in three sub-groups: STEAM, for the development of new HLT menus and monitoring their performance; STORM, for the development of HLT tools, code and actual configurations; and FOG, responsible for the online operations of the High Level Trigger. The Strategy for Trigger Evolution And Monitoring (STEAM) group is responsible for Trigger Menu development, path timing, trigger performance studies coordination, HLT offline DQM as well as HLT release, menu and conditions validation – in collaboration and with the technical support of the PdmV group. Since the end of proton-proton data taking, the group has started preparing for 2015 data taking, with collisions at 13 TeV and 25 ns bunch spacing.
The reliability of the extrapolation to higher energy is being evaluated comparing the trigger rates on 7 and 8 TeV Monte Carlo samples with the data taken in the past two years. The effect of 25 ns bunch spacing is being studied on the d. Smith Level-1 Trigger Hardware and Software The road map for the final commissioning of the level-1 trigger system has been set. The software for the trigger subsystems is being upgraded to run under CERN Scientific Linux 4 (SLC4). There is also a new release for the Trigger Supervisor (TS 1.4), which implies upgrade work by the subsystems. As reported by the CERN group, a campaign to tidy the Trigger Timing and Control (TTC) racks has begun.
The machine interface was upgraded by installing the new RF2TTC module, which receives RF signals from LHC Point 4. Two Beam Synchronous Timing (BST) signals, one for each beam, can now be received in CMS. The machine group will define the exact format of the information content shortly. The margin on the locking range of the CMS QPLL is planned for study for different subsystems in the next Global Runs, using a function generator. The TTC software has been successfully tested on SLC4.
Some TTC subsystems have already been upgraded to SLC4. The TTCci Trigger Supervisor. by Wesley Smith 2011-01-01 Level-1 Trigger Hardware and Software After the winter shutdown minor hardware problems in several subsystems appeared and were corrected. A reassessment of the overall latency has been made. In the TTC system shorter cables between TTCci and TTCex have been installed, which saved one bunch crossing, but which may have required an adjustment of the RPC timing. In order to tackle Pixel out-of-syncs without influencing other subsystems, a special hardware/firmware re-sync protocol has been introduced in the Global Trigger.
The link between the Global Calorimeter Trigger and the Global Trigger with the new optical Global Trigger Interface and optical receiver daughterboards has been successfully tested in the Electronics Integration Centre in building 904. New firmware in the GCT now allows a setting to remove the HF towers from energy sums. The HF sleeves have been replaced, which should lead to reduced rates of anomalous signals, which may allow their inclusion after this is validated.
For ECAL, improvements i. Smith 2011-01-01 Level-1 Trigger Hardware and Software Overall the L1 trigger hardware has been running very smoothly during the last months of proton running. Modifications for the heavy-ion run have been made where necessary. The maximal design rate of 100 kHz can be sustained without problems.
All L1 latencies have been rechecked. The recently installed Forward Scintillating Counters (FSC) are being used in the heavy ion run. The ZDC scintillators have been dismantled, but the calorimeter itself remains. We now send the L1 accept signal and other control signals to TOTEM. Trigger cables from TOTEM to CMS will be installed during the Christmas shutdown, so that the TOTEM data can be fully integrated within the CMS readout.
New beam gas triggers have been developed, since the BSC-based trigger is no longer usable at high luminosities. In particular, a special BPTX signal is used after a quiet period with no collisions. There is an ongoing campaign to provide enough spare modules for the different subsystems. Alimena 2013-01-01 Trigger Strategy Group The Strategy for Trigger Evolution And Monitoring (STEAM) group is responsible for the development of future High-Level Trigger menus, as well as of its DQM and validation, in collaboration and with the technical support of the PdmV group. Taking into account the beam energy and luminosity expected in 2015, a rough estimate of the trigger rates indicates a factor four increase with respect to 2012 conditions.
Assuming that a factor two can be tolerated thanks to the increase in offline storage and processing capabilities, a toy menu has been developed using the new OpenHLT workflow to estimate the transverse energy/momentum thresholds that would halve the current trigger rates. The CPU time needed to run the HLT has been compared between data taken with 25 ns and 50 ns bunch spacing, for equivalent pile-up: no significant difference was observed on the global time per event distribution at the only available data point, corresponding to a pile-up of about 10 interactions.
Hal-hal yang ditanyakan pada saat anamnesa meliputi: Anamnesa Rasional 1. Anamnesa Umum Biodata terdiri darai nama klien dan suami, usia, suku bangsa, agama, pendidikan terakhir, pekerjaan dan penghasilan serta alamat.Pada penderita dengan Hipertensi Kronis, usia biasanya lanjut atau lebih dari 35 tahun. Anamnesa kesehatan keluarga Terdiri dari penyakit keluarga klien, apa ada yang menderita penyakit keturunan (asma), diabetes mellitus, haemophili keturunan kembar dan penyakit kronis. Pada penderita dengan Hipertensi Kronis ditanya pula apakah dari pihak keluarga ada yang menderita penyakit hipertensi. Anamnesa kesehatan klien Yang perlu ditanyakan adalah sakit kepala, gangguan mata, nyeri perut atas, dan apakah sebelum hamil atau sebelum usia kehamilan 20-21 minggu pernah menderita hipertensi.
Anamnesa kebidanan terdiri dari Riwayat kehamilan ini ( keluhan nutrisi, pola eliminasi, astifitas, pola istirahat/tidur, seksualitas, imunisasi) Riwayat menstruasi (menarche, lama haid, siklus, jumlah darah haid, dismenorrhae, keluhan, hari pertama haid terakhir, fluor) Riwayat kehamilan, persalinan, nifas dan KB yang lalu, apakah pernah disertai dengan hipertensi. Dengan adanya biodata kita dapat mengenal klien serta diketahui permasalahan yang timbul sehingga lebih terbuka membicarakan masalah kepada petugas kesehatan.
C, 1996: 81) Dengan menanyakan penyakit/kesehatan keluarga dapat diketahui penyakit yang mempengaruhi kehamilan, langsung ataupun tak langsung. Graffiti fonts download for mac. C, 1996: 83) Dengan menanyakan gangguan subyektif kepada klien dapat membantu menegakkan diagnosa Dengan menanyakan riwayat kehamilan sekarang diharapkan petugas kesehatan mengetahui keadaan kehamilannya. C, 1996: 85) Dengan menanyakan riwayat menstruasi untuk membantuk menegakkan diagnosa (umur kelahiran) dan tafsiran persalinan Dengan menanyakan riwayat kehamilan, persalinan, nifas, KB yang lalu maka petugas kesehatan dapat memperkirakan kelainan pada kehamilan maupun persalinan.
Keadaan umum meliputi: - Postur tubuh klien (tinggi atau pendek) bentuk perut klien, ekspresi klien (lesu, pucat atau senang). C, 1996: 87) Tanda-tanda vital - Tekanan darah: pada usia kehamilan 20-30 minggu. Normalnya pada wanita hamil dibagi menurut umur sebagai berikut: 20 tahun: Tekanan darah 120/80 mmHg 20-30 tahun: Tekanan darah 110/70 mmHg (Ibrahim. C, 1996: 91).
Pada penderita dengan hipertensi kronis didapatkan tekanan darah 140/90 mmHg sebelum hamil atau sebelum usia kehamilan 20-21 minggu. Nadi: dihitung 15 menit dikalikan empat, menghitung dengannadi pada pergelangan tangannya. M, 1986: 28) - Suhu: suhu badan normalnya 36,5 oC-37.5 oC.
M, 1986: 14) - Respirasi: respirasi dihitung dari keteraturan pernapasan normalnya 18-24 x 1 menit. M, 1986: 28) Mengukur berat badan Beratbadan pertambahannya sampai hamil genap bulan lebih kurang 11-11,5 kg sehingga kenaikan rata-rata berat badan setiap minggu 0.5 kg. C,1996: 110) Pada penderita Hipertensi Kronis yang mengarah kearah superimposed pre eklampsia didapatkan kenaikan berat badan yang melebihi dari normal. Mengukur tinggi badan Pengukuran tinggi badan dilakukan pada ibu yang pertama kali datang.
Tinggi badan tidak boleh £ 145 cm. IBG, 1998: 37) Mengukur lingkaran lengan atas (LILA) normalnya ³23,5 cm. NI, 1995: 67) Dengan melihat keadaan umum pasien atau klien dapat diketahui keadaannya normal atau menunjukkan adanya kelainan Pada wanita hamil yang dikatakan darahnya lebih dari normal perlu mendapat pengawasan dan nasehat untuk banyak istirahat dan pengaturan denyut Pada penderita yang mengalami kehilangan darah maka frekuensi denyut nadi pergelangan tangan akan meningkat dan denyutnya lebih sukar diraba Pada penderita dengan suhu tubuh lebih dari 38 oC menunjukkan orang yang bersangkutan mengalami demam, kalau suhu tubuh kurang dari 35 oC maka orang tersebut mengalami suhu rendah. Dengan menghitung pernapasan dapat kita ketahui apakah pernapasan penderita terhenti sama sekali atau tidak, sehingga perlu segera diambil tindakan untuk menyelamatkan penderita Dengan mengukur berat badan dan memantau hasilnya.
Pada kenaikan berat badan yang lebih dari 0,5 tiap minggunya dan disertai adanya aedema pada trimester III harus diwaspadai Dengan mengukur tinggi badan dapat kita ketahui apakah ibu hamil masih belum katagori resiko tinggi atau resiko rendah Dengan mengukur LILA dapat diketahui status gizi ibu (apakah mengalami kekurangan energi kalori atau tidak). Rasional Kepala dan muka (muka, mata, hidung, bibir dan gigi), apakah ada oedema dan gangguan penglihatan. Keadaan leher (kelenjar gondok, linfe, struma, pembesaran vena jogularis) Keadaan buah dada (betuk, warna kelainan, puting susu, coloustrun) Keadaan perut (bentuk perut, pembesaran, striae, linea, luka parut) Keadaan vulva (aedema, tandu chadwik, varisei, fluxus, flour, candi lama) Keadaan tungkai (aedema, varises, luka dari pangkal paha samapai ujung kaki) Dengan melihat kepala dan muka dapat disampaikan keadaan klien sehat, gembira, sakit atau sedih.
C, 1996: 112) Dengan melihat keadaan leher adalah pembesarannya kemungkinan adanya gangguan kardiokvasikuler. C, 1996: 113) Dengan melihat keadaan buah dada dapat diketahui bentuk puting susu sehingga bila ada kelainan harus mendapat perawatan atau pemeliharaan yang baik.
C, 1996: 114) Dengan melihat perut bila ada luka parut mungkin akan berpengaruh atau mempengaruhi kehamilan dan persalinan. C, 1996: 114) Dengan melihat keadaan vulva untuk mencegah terjadinya infeksi waktu persalinan maupun nifas. C, 1996: 115) Dengan melihat anggota bagian bawah terutama tungkai dapat dipakai untuk menegakkan diagnosa. C, 1996: 115). Hal-hal yang diperiksa meliputi: Pemeriksaan Rasional Leher meliputi kelenjar thygroid, linfe dan vena jogularis Dada meliputi benjolan, nyeri tekan pada payudara, pengeluaran coloustrum Abdomen meliputi leopold I, II, III, IV Tungkai Dengan pemeriksaan palpasi pada leher untuk mengetahui kelainan seacara dini Dengan pemeriksaan dada untuk mengetahui adanya tumor payudara dan pengeluaran coloustrum Dengan palpasi abdomen maka dapat diketahui usia kehamilan dan posisi janin Dengan palpasi tungkai maka dapat diketahui adanya kelainan yang menyertai kehamilan.
C, 1996: 121). Rencana Rasional 1. Diagnosa Multigravida dengan hypertensi kronis Tujuan: Setelah dua minggu dilakukan asuhan kebidanan maka gejala hypertensi kronis hilang Kriteria hasil: Tekanan darah £ 140/90 mmHg, pemeriksaan kehamilan normal Rencana Jelaskan pada klien tentang kehamilan nya dan hal-hal yang harus diperhatikan Anjurkan pada klien istirahat yang cukup setidakanya 1 jam pada siang hari dan 10 jam pada tidur malam. Anjurkan pada klien untuk mengkonsumsi diet gizi seimbang.
Kolaborasi dengan dokter untuk pemberian obat anti hypertensi. Jelaskan tanda-tanda bahaya kehamilan dan anjurkan untuk segera ke rumah sakit bila ada tanda-tanda itu. Anjurkan pada klien untuk kontrol satu minggu atau sewaktu-waktu bila ada keluhan. Masalah Gangguan rasa nyaman, pusing Tujuan: Setelah 7 hari dilaksanakan asuhan kebidanan pada klien dengan hypertensi kronis rasa nyaman terpenuhi Kriteria: Keluhan kepala pusing tidak ada tekanan darah £ 140/90 mm Hg klien merasa nyaman Rencana: Kaji penyebab timbulnya rasa pusing pada klien Jelaskan pada klien tentang cara mengatasi rasa pusing Anjurkan pada klien untuk sering jalan-jalan pagi hari sesuai batas kemampuan Kebutuhan: HE tentang kehamilan resiko tinggi.
Tujuan: Setelah diberikan asuhan kebidanan pada ibu hamil multigravida dengan hypertensi kronis selama 24 jam, klien memahami akan kehamilannya.