Pengelolaan Pelayanan dan Asuhan Keperawatan pada Klien TB Paru dengan Gejala Batuk Produktif melalui Penerapan Teknik Batuk Efektif di Puskesmas Medan Johor

Abstract

Pulmonary tuberculosis remains a global health problem, with Indonesia contributing the second highest number of cases in the world. Puskesmas Medan Johor recorded 494 cases of pulmonary TB in 2023, where the problem of ineffective airway clearance is often experienced by patients. The purpose of this paper is to evaluate the effectiveness of effective cough techniques in overcoming these problems through a comprehensive nursing care approach. The method used was the five-stage nursing process (assessment, diagnosis, planning, implementation, and evaluation) in a 30-year-old male patient Mr. K with symptoms of productive cough ≥2 weeks, shortness of breath, and initial oxygen saturation of 96%. The intervention was conducted for 4 days (June 9-12, 2025) including training in effective cough techniques, semi-Fowler positioning (30-45°), vital sign monitoring, and education. The results showed significant improvement in clinical parameters, including oxygen saturation which rose from 96% to 99%, respiratory frequency decreased from 26x/min to 21x/min (normal), as well as the patient's ability to practice effective coughing techniques independently and complaints of fatigue when coughing. Based on the nursing care process that has been carried out, it can be concluded that effective coughing techniques can improve airway clearance in pulmonary TB patients, supported by improvements in respiration parameters and patient independence. A holistic approach involving the family also accelerates recovery.