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Introduction: Hypertension is an increase in systolic blood pressure ≥140 mmHg and/or diastolic ≥90 mmHg that has the potential to cause serious complications. The prevalence of hypertension in Indonesia is 34.11% (Riskesdas, 2018), in Central Java 37.57%, and in Tonjong Village 15,951 patients aged ≥15 years were recorded (Tonjong Health Center, 2025). Purpose: To provide direct and comprehensive family nursing care to Ny. T, the family of Tn. D, with hypertension in Tonjong Village, Dukuh Kauman RT 03 RW 04, Tonjong District, Brebes Regency. Method: Case study with a nursing process approach. Data were collected through interviews, observation, physical examination, and documentation, conducted on December 26–29, 2025. Results: Assessment revealed that Ny. T complained of dizziness, neck pain, difficulty sleeping, and soreness in both legs with blood pressure of 167/100 mmHg. The family had no knowledge about hypertension. Two diagnoses were established: Acute Pain (D.0077) and Knowledge Deficit (D.0111). Interventions included complementary foot massage therapy to address acute pain and health education on hypertension. After three visits, the Acute Pain diagnosis was partially resolved with a decrease in pain scale from 3 to 2 and blood pressure from 167/100 mmHg to 150/95 mmHg, while the Knowledge Deficit diagnosis was fully resolved. Conclusion: Family Nursing Care with the SDKI, SLKI, and SIKI approach had a positive impact on improving the condition of Ny. T. It is recommended that the client continue foot massage independently, implement the five family health tasks, and routinely utilize health facilities.

Introduction: Appendectomy is a relatively safe surgical procedure. One important aspect of this stage is maintaining the patient's mental stability, especially before administering anesthesia. However, anesthesia often causes anxiety in patients. Mindfulness-based cognitive therapy has been shown to significantly improve quality of life by minimizing anxiety. Objective: This study analyzed the effect of Mindfulness-based cognitive therapy (MCT) in reducing pre-anesthetic anxiety in appendectomy patients. Methods: This study used a case study design with a nursing care process approach. The subjects in this case study were two patients who met the inclusion criteria. The instrument used was an observation sheet according to the Indonesian Society for Anesthesia and Clinical Trials (SLKI). Results: The results of the case study showed that both patients experienced pre-anesthetic anxiety. After receiving Mindfulness-based cognitive therapy, pre-anesthetic anxiety decreased. Conclusion: This case study demonstrated that pre-anesthetic anxiety decreased after Mindfulness-based cognitive therapy.

Disorders of the musculoskeletal system encompass a wide range of conditions affecting the bones, joints, and muscles. Bone-related disorders include osteoporosis, fractures, spinal deformities, osteopenia, osteomalacia, Paget’s disease of bone, osteopetrosis, achondroplasia, osteogenesis imperfecta, and osteomyelitis. Joint-related disorders consist of arthritis, bursitis, tendinitis, tendon injuries, tennis elbow, and carpal tunnel syndrome, while muscle disorders include myalgia, fibromyalgia, muscle injuries, muscular dystrophy, muscle atrophy, cramps, and spasms (Astuti et al., 2024). Fractures may lead to complications in surrounding tissues, such as soft tissue edema, bleeding into muscles and joints, joint dislocation, nerve damage, vascular injury, and tendon rupture (Rumapea, 2024). A patellar tendon rupture occurs when the fibrous tissue connecting the patella to the quadriceps muscle tears, and complete ruptures typically require surgical repair. The objective of this study was to design and implement a nursing care plan for patient A, who underwent post-operative management of a patellar tendon rupture in Mawar Ward 2 at RSUD dr. Soeselo, Tegal Regency, in 2025. This study applied a descriptive case study method. The findings revealed that the main complaint reported by the patient was pain in the left knee. Three nursing diagnoses were identified: acute pain, impaired physical mobility, and risk of infection. Nursing interventions were structured based on standardized guidelines from SDKI, SLKI, and SIKI, enabling systematic implementation. The results highlight the importance of comprehensive and evidence-based nursing care to optimize recovery outcomes for patients with post-operative tendon rupture.

Hypertension is one of the most common non-communicable diseases, with a high incidence rate that has become a major global health concern. It is often referred to as a “silent killer” because many patients are unaware of their condition until serious complications arise. In Indonesia, the prevalence of hypertension is relatively high, yet many sufferers remain undiagnosed or do not receive proper medical treatment. Several risk factors contribute to hypertension, including age, heredity, high-salt diet, obesity, lack of physical activity, and unhealthy lifestyles such as smoking and alcohol consumption. Without proper management, hypertension may lead to severe complications such as stroke, heart failure, and chronic kidney disease. Management of hypertension generally involves pharmacological therapy, such as the administration of antihypertensive drugs, as well as non-pharmacological interventions through lifestyle modifications. Nurses play a crucial role in patient education, monitoring, and preventing complications through comprehensive nursing care. The purpose of this study is to describe the nursing care provided to Mr. R, who experienced a cardiovascular system disorder, namely hypertension, in the Dahlia Ward of RSUD dr. Soeselo, Tegal Regency. The research method used was descriptive with a case study approach, allowing for a systematic and clear presentation of the patient’s condition. The case findings showed that the patient’s main complaint was a headache radiating to the nape of the neck. Based on nursing assessment, two nursing diagnoses were identified: acute pain and lack of knowledge regarding the disease and its management. Interventions were determined using national standards such as SDKI, SLKI, and SIKI, which are expected to reduce symptoms and improve the patient’s understanding of hypertension.

When problems such as antepartum hemorrhage, fetal distress, atypical fetal presentation, and gestational hypertension occur, a cesarean section can save the lives of both mother and baby. A cesarean section (CS) is a surgical technique in which the uterus and abdominal wall are opened to deliver the fetus. In many countries, cesarean sections are the most common surgical procedure, and over the past 30 years, their use has gradually increased. Intrauterine fetal death is the death of a fetus weighing 500 grams or more in the womb at 20 weeks of gestation or later. The partial or complete separation of a normally implanted placenta after 22 weeks before birth is known as placental abruption. he purpose of this paper is to provide nursing care to Mrs. P with a Caesarean section indicating intra uterine fetal death (IUFD) due to placental abruption in the Nusa Indah room of dr. Soeselo Regional General Hospital, Tegal Regency, according to nursing standards. The method used is descriptive with a case study approach. The data collection techniques in this scientific paper are in the form of interviews, observations, documentation studies and literature studies. From the case review, the main complaint was pain in the operated area, pain increased when moving, pain like being squeezed with a pain scale of 5, pain that comes and goes. The patient appeared to be grimacing in pain and restless, the patient always held the area that had been operated on, the results of the vital signs examination obtained: BP: 139/100 mmHg, pulse: 103 x / minute, S: 36.5oC, RR: 20 x / minute, there was a bandage on the lower abdomen along 15 cm with a horizontal line, the patient did not know and was confused about the birth control used after the CS. The nursing problems identified were acute pain, risk of infection, and knowledge deficit. Interventions were developed based on the theory in the SDKI, SLKI, and SIKI, as well as the client's condition, and were implementable

The endocrine system is a ductless body control system that produces hormones to regulate various organs and physiological processes. Hormones act as important biological messengers in the human body. One of the most essential hormones is insulin, which plays a key role in blood sugar regulation. Insufficient insulin production or impaired insulin action can cause disruption of blood glucose control, leading to diabetes mellitus. Diabetes mellitus is a chronic metabolic disorder characterized by persistently high blood glucose levels caused by impaired insulin secretion, insulin action, or both. The purpose of this paper is to apply nursing care to Mr. N, a patient with endocrine system disorders: diabetes mellitus, treated in the Dahlia Ward of Dr. Soeselo Regional Hospital, Tegal Regency. This descriptive case study method was used to explain the nursing process in a structured manner. The main complaint presented by the client was pain in the wound on the left foot. Four nursing diagnoses were identified during the assessment, namely unstable blood glucose levels, acute pain, impaired skin/tissue integrity, and knowledge deficit. Nursing interventions were developed and implemented based on the Standar Diagnosis Keperawatan Indonesia (SDKI), Standar Luaran Keperawatan Indonesia (SLKI), and Standar Intervensi Keperawatan Indonesia (SIKI). The case highlights the importance of comprehensive nursing care in diabetes management, with a focus on blood glucose stabilization, pain management, wound care, and patient education. The results of this study are expected to provide additional references for clinical practice and strengthen the role of nurses in preventing complications of diabetes mellitus.

The digestive system plays a role in processing food into nutrients so that they can be absorbed and utilized by the body, but it is often found that the digestive system experiences disorders that can be caused by various factors such as infection, inflammation, motility disorders, or even neoplasms (Suryati et al., 2025).One of the diseases caused by digestive system disorders is ileus obstruction, which is a disorder of the digestive system that occurs due to a mechanical blockage in the intestine and is often found in patients with intestinal obstruction. One of the diseases resulting from digestive system disorders isileus obstruction, which is a disorder of the digestive system caused by a mechanical obstruction in the intestines and is commonly found in patients who visit the emergency room. It is estimated that approximately 2-8% and 15% of patients require treatment in the surgical unit (Andi Nailah et al., 2024). Obstructive ileus occurs in the small intestine and can be caused by incarcerated hernia, intussusception, intestinal adhesions or adhesions, ascariasis, volvulus, tumors, or gallstones entering the ileum (Su’un, Gani, & Purnama, 2024). The purpose of this writing is to understand and provide nursing intervention  for Mrs. T with a digestive system disorders: a case of ileus obstruction in Mawar 2 ward dr. Soeselo Regional General Hospital, Tegal Regency. The method used in this writing is a descriptive method. From the case review, it was found that the patient's main complaint was pain in the lower right abdomen. Three diagnoses emerged: acute pain, anxiety, and knowledge deficit. Interventions were developed based on SDKI, SLKI, and SIKI, which can be implemented.

Post-operative care is a critical phase in the recovery process, beginning immediately after the completion of surgery until the patient is stabilized and transferred to the inpatient ward. Among various surgical procedures, lumpectomy is a common intervention performed to manage mammary tumors, aiming to preserve breast tissue while removing the tumor (Arif et al., 2021). This paper presents a case study of Mrs. D, a patient with an endocrine disorder who underwent a right breast lumpectomy at Mawar 2 Ward, Dr. Soeselo Regional General Hospital, Tegal Regency. The study employed a descriptive method to explore the patient’s condition and nursing interventions. Upon assessment, the main complaint reported by the patient was pain localized in the post-operative area. Based on the findings, two primary nursing diagnoses were established: acute pain related to surgical trauma and knowledge deficit related to post-operative care and self-management. Nursing interventions were designed and implemented according to the Indonesian Nursing Diagnosis Standard (SDKI), the Indonesian Nursing Outcomes Standard (SLKI), and the Indonesian Nursing Interventions Standard (SIKI). Interventions included pain management strategies, such as pharmacological support and non-pharmacological relaxation techniques, as well as health education to improve patient knowledge and self-care ability. The case highlights the importance of comprehensive nursing care that addresses both physical discomfort and the patient’s understanding of recovery, thereby promoting optimal health outcomes after breast surgery.

Post-cesarean section (SC) patients with premature rupture of membranes (PROM) require comprehensive nursing care due to their high risk of pain, infection, and limited mobility. This case study aims to describe the nursing care process applied to a 39-year-old woman post-SC with PROM indication. The study was conducted over five days in Nusa Indah Room at RSUD dr. Soeselo, Tegal. Data collection included interviews, observation, physical examination, and medical record review. The nursing interventions were guided by the Indonesian Nursing Diagnosis Standards (SDKI), Interventions (SIKI), and Outcomes (SLKI). Results showed a reduction in pain scale from 6 to 2, improved mobility, and wound healing without signs of infection or bleeding. These findings indicate that structured and holistic nursing care, combined with patient education and family involvement, can significantly enhance recovery outcomes. The implications suggest the need for clinical protocols in managing post-SC patients with PROM to ensure consistent, evidence-based nursing practice.

Post-cesarean section (SC) patients with premature rupture of membranes (PROM) require comprehensive nursing care due to their high risk of pain, infection, and limited mobility. This case study aims to describe the nursing care process applied to a 39-year-old woman post-SC with PROM indication. The study was conducted over five days in Nusa Indah Room at RSUD dr. Soeselo, Tegal. Data collection included interviews, observation, physical examination, and medical record review. The nursing interventions were guided by the Indonesian Nursing Diagnosis Standards (SDKI), Interventions (SIKI), and Outcomes (SLKI). Results showed a reduction in pain scale from 6 to 2, improved mobility, and wound healing without signs of infection or bleeding. These findings indicate that structured and holistic nursing care, combined with patient education and family involvement, can significantly enhance recovery outcomes. The implications suggest the need for clinical protocols in managing post-SC patients with PROM to ensure consistent, evidence-based nursing practice.

A tumor is a collection of abnormal cells that develop due to excessive and uncontrolled cell division (Angkotasan & Vioneery, 2022). Currently, tumors are considered one of the leading causes of morbidity and mortality worldwide (Maryati, 2023). The purpose of this study is to provide an in-depth understanding and description of nursing care for Mr. T, a patient with a medical diagnosis of post-operative soft tissue tumor (STT) in the right arm, who was treated in Room Mawar 2 at RSUD dr. Soeselo, Tegal Regency, in accordance with standardized nursing care guidelines. This study employed a descriptive case study method, with data obtained through interviews, observations, physical examinations, and documentation reviews. Based on the case analysis, the patient’s main complaint was severe pain following surgery. Three priority nursing diagnoses were identified: acute pain, knowledge deficit related to the disease and its management, and risk of infection due to post-surgical wound. Nursing interventions were planned and implemented according to SDKI (Standar Diagnosa Keperawatan Indonesia), SIKI (Standar Intervensi Keperawatan Indonesia), and SLKI (Standar Luaran Keperawatan Indonesia), adapted to the patient’s condition. The interventions included pain management techniques, health education, wound care, and infection prevention strategies. The results showed that after the nursing care was carried out, the patient reported a decrease in pain intensity, demonstrated increased knowledge regarding his condition, and exhibited no signs of infection. This study highlights the importance of systematic nursing care in post-operative soft tissue tumor patients to reduce complications, promote recovery, and improve quality of life. The findings are expected to contribute as a reference for nursing practice and further research on tumor management in clinical settings.

Effective nursing documentation and optimal nurse performance are essential pillars of high-quality healthcare services. Despite standardised guidelines being available, incomplete documentation and low compliance rates persist in various hospital settings. This study investigated the impact of implementing the 3S-based Nursing Care Guidelines, comprising standardised nursing diagnoses (SDKI), interventions (SIKI), and outcomes (SLKI), along with structured supervision by the hospital's nursing committee, on improving documentation quality and nurse performance. Employing a true experimental pre-posttest control group design, the research involved 49 nurses allocated into three groups: control, intervention with 3S, and intervention with 3S combined with the supervision nursing committee. Data were collected through observation sheets, document audits, and performance checklists. Statistical analyses using Wilcoxon, Mann-Whitney U, and Kruskal-Wallis tests revealed significant post-intervention improvements (p = 0.000) in both outcome areas. The results affirm that integrating structured care models and active supervision effectively enhances the quality of nursing care delivery.

Background: Osteoarthritis (OA) is a degenerative disease that often causes pain, disability and limited mobility, especially in the elderly. Total Knee Replacement (TKR) is one of the preferred surgical interventions in severe OA to reduce pain and improve joint function. Objective: This case report aims to evaluate nursing care in a 76-year-old female patient with OA genu grade III postoperative TKR sinistra accompanied by acute pain, impaired physical mobility, and risk of infection. Methods: This study is a case report using interview techniques, observation, physical examination, and documentation study. Nursing management was carried out based on the Indonesian Nursing Diagnosis Standards (SDKI), Indonesian Nursing Outcome Standards (SLKI), and Indonesian Nursing Intervention Standards (SIKI). Prioritized nursing diagnoses include acute pain, impaired physical mobility, and risk of infection. Results: After 3x24 hours of intervention, there was a decrease in the patient's pain scale from 5 to 3 (0-10 scale). Left lower limb muscle strength increased, with active range of motion. The surgical wound remained dry with no sign of infection, and the patient was able to sit on the edge of the bed with minimal assistance. Conclusion: The application of nursing care based on SDKI, SLKI, and SIKI showed significant results in improving the patient's condition. The Evidence-Based Nursing (EBN) approach contributed greatly to the recovery of patients after TKR surgery. This intervention can be a reference for nurses in designing nursing care in similar cases.

Background: Pelvic fractures are common injuries resulting from high-energy trauma, such as traffic accidents or falls from height. These injuries can cause decreased mobility function, pain, and risk serious complications. A common treatment that can be done is Open Reduction Internal Fixation (ORIF) to improve bone stability and patient mobility function. Objective: this study is to provide nursing care for patients with post-ORIF pelvic fractures to improve nursing outcomes, including pain management, physical mobility, and skin integrity. Methods: This study used a case report approach where the source of research data came from interviews, observations, physical examinations, and patient documentation. Nursing care was organized based on the Indonesian Nursing Diagnosis Standards (SDKI), Indonesian Nursing Intervention Standards (SIKI), and Indonesian Nursing Outcome Standards (SLKI). Results: After the intervention, the patient showed a decrease in pain from scale 6 to scale 3 with the use of PMR. Improved physical mobility was observed through regular ROM exercises, and skin integrity was maintained with position changes and routine wound care. No complications occurred post intervention. Conclusion: Comprehensive nursing care in patients with post-ORIF pelvic fractures can accelerate healing and reduce the risk of complications. Integrated interventions, including pain management, mobility, and skin care, play an important role in supporting patient recovery. The nurse's role in observation and collaboration with the medical team is essential to improve patient outcomes and quality of life.

Background : Nurses play an important role in providing nursing care to Space Occupying Lession (SOL) patients. Nurses directly assist patients and educate them about their disease and prevent rehospitalization. During hospitalization, patients require hemodynamic stabilization monitoring, use of various monitoring and life support devices, postoperative patient care, and crisis management in the event of loss of consciousness or sedation programs.  Purpose : This case study aims to perform 30ᵒ head elevation with SOL Intracranial o/t (L) Temporoparietal who has head pain. Methods : This research is a case report where the source of research data comes from the patient and the patient's family using interview techniques, observation, physical examination, and documentation study of nursing management prioritized according to the SDKI (Indonesian Nursing Diagnosis Standard), SLKI (Indonesian Nursing Outcomes Standard), and SIKI (Indonesian Nursing Intervention Standard): acute pain, decreased intracranial adaptive capacity and impaired physical mobility. Results : Decreased pain quality, increased intracranial adaptive capacity, and decreased physical mobility impairment indicate improvement in the patient's condition along with the nursing care provided. Conclusion : The results of routine nursing implementation coupled with the application of evidence-based nursing practice 30ᵒ head elevation intervention (30ᵒ head position intervention) to reduce pain along with the collaboration of pharmacological therapy administration of ketorolac injections were found to reduce the pain scale from a scale of 3 - 4 (mild - moderate) NRS to a pain scale of 2 (mild) NRS.

Diabetes mellitus is one of th non-communicable diseases (NCDs) caused bt metabolic disorders. The purpose of this paper is to determine and provide family nursing care for Mr. T with enocrine system disorders: diabetes mellitus in Kalibuntu Village Losari District, Brebes Regency according to nursing standards. The method used is the descriptive methode in the form of interviews, observations and examinaton. From the case review, it was found that the client’s main complaint was that the client’s mai complaint was that his feet felt tingling when walking too long and there weres, GDS : 267 mg/dl. The nursing problems found were untable blood glucose levels and knowledge deficit. Intervies ere arranged and knowledge on the were unstable blood glucose levels and knowledge deficits. Interventions were arranged based on the theory in SDKI, SLKI and SIKI as well as on the client’s condition and could be implemented.

Hypertension is a condition where there is an abnormal and continuous increase in blood pressure caused by one or several risk factors that do not work as they should in maintaining normal blood pressure (Majid, 2018). The signs and symptoms in hypertensive patients are the onset of pain. due to increased blood pressure. The purpose of this writing is to find out and provide nursing care to Mr.  T With Cardiovascular System Disorders: Hypertension in Kalibuntu Village Rt 02 Rw 02 Losari District, Brebes Regency in accordance with nursing standards. The methods used are descriptive methods and data collection methods. From the case review, it was found that Mr. T complains of pain. There were two diagnoses found, namely acute pain and knowledge deficit. Interventions are prepared based on the theory of SDKI, SLKI and SIKI as well as on the client's condition and can be implemented.

Indonesia still faces big challenges in developing public health. Changing people's lifestyles are one of the reasons for the shift in patterns from infectious diseases to non-communicable diseases (epidemiological transition). One of the non-communicable diseases that occupies the fourth position as the cause of death is diabetes mellitus, which was recorded as contributing 1.5 million cases in 2019 (Sarifah & Siyam, 2023). The signs and symptoms in diabetes mellitus patients are high blood sugar levels. The purpose of this writing is to find out and provide family nursing care to Mrs. S Family Mr. N With Endocrine System Disorders: Diabetes Mellitus in Bonjot Hamlet, Kalibuntu Village, RT 02 RW 04, Losari District, Brebes Regency, in accordance with nursing standards. The methods used are descriptive methods and data collection methods. From the case review, it was found that Mrs. S complains of frequent urination. There were two diagnoses found, namely knowledge deficit and instability of blood glucose levels. Interventions are prepared based on the theory of SDKI, SLKI and SIKI as well as on the client's condition and can be implemented.

Cholelithiasis or gallostones is a digestive tract disease caused by the accumulation of solid mass deposits in the vesica fellea ar gallbladder. The purpose of this paper is to find out and provide nursing care to Mr. S with cholelithiasis is the dahlia ward of dr. Soeselo hospital, Tegal Regency according to nursing standards. The methods used were interviews, medical history, physical examinations and laboratory examination results and diagnoses to create basic assessment data. From the case review, it was found that the patient’s main complaint was shortness of breath. The nursing problems found were hypervolemia and knowledge deficit. Interventions were arranged based on the theory in SDKI, SLKI and SIKI as well as on the client’s condition and could be implemented.

A fracture or what is called a broken bone is an event that often occurs due to trauma or physical exertion which can cause disability and even complications (Appley & Solomon, 2021). The signs and symptoms in fracture patients include pain. The purpose of this writing is to find out and provide nursing care to An. E with musculoskeletal system disorders: post-operative open reduction internal fixation right clavicle fracture in the rose room 2 RSUD dr. Soeselo Tegal Regency in accordance with nursing standards. The methods used are descriptive methods and data collection methods. From the case review, it was found that An's main complaint was. E complains of pain. There were two diagnoses found, namely acute pain, impaired skin and tissue integrity. Interventions are prepared based on the theory of SDKI, SLKI and SIKI as well as on the client's condition and can be implemented.