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Background: Congestive Heart Failure (CHF) is a condition in which the heart is unable to pump blood effectively due to structural or functional disorders, commonly manifesting as dyspnea, fluid retention, and peripheral edema. Globally, cardiovascular disease is the leading cause of death, with CHF affecting more than 55-65 million people worldwide. Objective: To perform comprehensive nursing care on patient Ny. A with cardiovascular system disorder: Congestive Heart Failure (CHF) in the Mawar I Ward of RSUD dr. Soeselo, Tegal Regency. Methods: This study used a descriptive method through a case study approach. Data were collected via interview, observation, and physical examination. Results: Four nursing diagnoses were identified: ineffective breathing pattern, hypervolemia, activity intolerance, and knowledge deficit. Interventions included respiratory monitoring, hypervolemia management, energy management, and health education on disease process. After two days of nursing implementation, three diagnoses were resolved and one (hypervolemia) was partially resolved. Conclusion: Nursing care for Ny. A with CHF was carried out through assessment, nursing diagnosis, intervention, implementation, and evaluation. Continued interventions are recommended, including fluid balance monitoring, diuretic collaboration, and edema and ascites monitoring.

Background: Sectio Caesarea (SC) is a surgical procedure to deliver the fetus through an incision in the abdominal and uterine wall. Patients with a history of previous sectio caesarea frequently experience acute pain, risk of infection, and lack of knowledge regarding post-SC contraception, requiring comprehensive nursing care. Objective: To describe the application of nursing care in a patient with post-operative sectio caesarea with a history of sectio caesarea indication. Methods: This study used a descriptive method with a case study approach. Data were collected through interviews, observation, documentation, and relevant literature review. Results: Assessment of Ny. S revealed three nursing diagnoses: acute pain, knowledge deficit, and risk of infection. Interventions included pain management, family planning (KB) health education, and infection prevention through wound care. Following nursing interventions, the knowledge deficit resolved completely, while acute pain and risk of infection were partially resolved. Conclusion: Systematic nursing care can effectively address nursing problems in post-SC patients and improve patient health outcomes.

Diabetes mellitus (DM) is a chronic metabolic disease characterized by elevated blood glucose levels due to insufficient insulin production or ineffective insulin utilization. The prevalence of DM in Indonesia reached 11.7% in the 2023 National Health Survey, with Brebes Regency recording 568 DM cases in 2025 and increasing to 157 cases in Tonjong Village in January 2026. This case study aims to describe comprehensive nursing care for Ny. M, a 52-year-old patient diagnosed with endocrine system disorder (diabetes mellitus), in the family of Tn. I at Karang Anyar Village, Tonjong District, Brebes Regency. The method used was a case study with data collection through interview, observation, physical examination, blood glucose measurement, and literature review conducted on December 26–28, 2025. The assessment found subjective data: the patient frequently felt fatigue, tingling in both legs, excessive thirst, and increased urination frequency. Objective data: pale and fatigued face, blood pressure 150/100 mmHg, pulse 95x/min, respiration 22x/min, temperature 36.7°C, and random blood glucose (RBG) 155 mg/dl. Two nursing diagnoses were established: blood glucose instability and readiness for enhanced knowledge. Interventions implemented included hyperglycemia management (monitoring blood glucose, dietary education, complementary herbal therapy with ginger and honey), and health education regarding DM complications. Evaluation results showed that after 2 days of nursing visits, fatigue decreased, blood glucose improved (RBG 130 mg/dl), and the patient's knowledge about DM complications was resolved.

Preeclampsia is one of the leading causes of maternal mortality and may result in various complications during pregnancy and childbirth. In Tegal Regency, preeclampsia contributed to 27% of maternal deaths in 2024; therefore, studies on childbirth characteristics among mothers with this condition are needed. This study aimed to identify the characteristics of childbirth events in mothers with preeclampsia at Dr. Soeselo Slawi Regional Hospital, Tegal Regency. A descriptive design with a retrospective approach was used by reviewing the medical records of 202 mothers who delivered with preeclampsia during 2025. Data were analyzed univariately and presented as frequency distributions and percentages. The results showed that most mothers underwent operative delivery (62.38%), while spontaneous and induced labor accounted for 37.13% and 0.50%, respectively. Most deliveries occurred at preterm gestational age (62.38%), followed by term (36.14%) and postterm (1.49%) deliveries. Maternal and obstetric complications included bleeding (6.93%), fetal distress (4.95%), eclampsia (1.49%), and HELLP syndrome (0.99%). Most neonates had normal birth weight (82.18%) and did not require NICU care (95.05%), although low birth weight (17.82%) and NICU admission (4.95%) were still identified. The maternal clinical condition was dominated by blood pressure of 140–159/90–109 mmHg (75.74%). Proteinuria was found in 46.53% of respondents, with moderate proteinuria (+2) as the predominant category (38.30%). In conclusion, childbirth among mothers with preeclampsia was dominated by operative and preterm deliveries. These findings emphasize the importance of early detection and optimal management of preeclampsia to reduce maternal and neonatal complications and improve the quality of maternal-infant health services overall.

Gout arthritis is joint inflammation that occurs suddenly due to the accumulation of excess uric acid levels in the body (hyperuricemia). In Indonesia, based on the 2018 Basic Health Research, the prevalence of gout diagnosed by health workers ranges from 11.9% to 24.7%, with the highest rates in the elderly age group. This scientific paper aims to provide family nursing care for Mr. T and family with musculoskeletal system disorder: gout arthritis in Tonjong Village, Karanganyar Hamlet, RT 03 RW 04, Tonjong District, Brebes Regency. The method used is narrative descriptive, focusing on nursing care given to patients according to the stages of the nursing process. The method of data collection includes observation, interview, and documentation. The nursing diagnoses that emerged were impaired physical mobility and knowledge deficit. Nursing interventions included ambulation support, oral medication administration, massage therapy, and health education. After 2 days of nursing implementation, the evaluation results showed that both nursing diagnoses of impaired physical mobility and knowledge deficit were resolved.

Background: Community nursing is a specialty field that combines nursing science skills, public health sciences, and social assistance in addressing individual and family health problems, including non-communicable diseases such as gout arthritis. Gout arthritis is a metabolic disease characterized by pain and joint inflammation due to the accumulation of purine crystals (hyperuricemia). The WHO reports a prevalence of gout arthritis reaching 3.74% globally, while in Indonesia the prevalence reaches 11.9% based on health worker diagnosis. In Brebes Regency, the prevalence reaches 13.67%, with 3,078 sufferers out of 22,550 productive-age population. Objective: To provide comprehensive community nursing care to Ny. R with musculoskeletal system disorder: gout arthritis in Tonjong Village, Tonjong District, Brebes Regency. Method: This study uses a case study approach with data collection through interview, observation, physical examination, and documentation study conducted on December 26–28, 2025. Results: Assessment findings showed that Ny. R, a 60-year-old woman, had a history of gout arthritis for 3 months with uric acid levels of 9.6 mg/dL, complaining of pain and aching in the left foot with pain scale 3. Two nursing diagnoses were established: acute pain and knowledge deficit. Nursing interventions included pain management, uric acid level monitoring, lemongrass stem decoction foot soak complementary therapy, and health education using leaflets. After 2 days of implementation, uric acid levels decreased to 8.2 mg/dL and pain scale decreased to 2. Conclusion: Community nursing care through complementary therapy (lemongrass stem decoction foot soak) and health education effectively reduced pain and improved knowledge about gout arthritis in Ny. R.

Indonesia is currently experiencing an emergency situation regarding sexual violence, which compromises national social resilience. The enactment of the Sexual Violence Crimes Law (UU TPKS) creates new legal mandates for healthcare professionals. Midwives, serving as frontline providers in primary care and remote areas, act as the first professional contact for survivors, yet they lack adequate legal certainty regarding medico-legal duties and preparedness within the midwifery educational framework. Objectives: This study aims to analyze the regulatory synchronization concerning the limited medico-legal authority of midwives in implementing the UU TPKS and to formulate reconstruction strategies for professional standards and the national midwifery curriculum. Methods: This normative juridical (doctrinal) research utilizes statute, conceptual, analytical, and comparative approaches. Data analysis was conducted qualitatively-normatively through systematic and teleological interpretations, evaluated using coherence and prescriptive frameworks. Results: The study reveals a significant disharmony of norms between the UU TPKS and Minister of Health Regulation (Permenkes) No. 2 of 2025, which imposes bureaucratic barriers on safe abortion access for rape victims. Additionally, the Midwife Professional Standards (Kepmenkes No. 320/2020) fail to integrate basic clinical forensic authorities, compounded by a national techno-centric curriculum that overlooks Trauma-Informed Care (TIC). Conclusions: Legal certainty for midwives and comprehensive justice for survivors can only be accomplished by reconstructing inclusive competency standards, eliminating administrative boundaries through the "Medical First" principle, and integrating primary health law and trauma-sensitive care modules into the national midwifery curriculum.

Non-Communicable Diseases (NCDs) such as Diabetes Mellitus and Gout pose a serious threat to the health of the elderly due to their often asymptomatic nature. Cost barriers hinder the elderly community from accessing laboratory services. This community service activity aims to improve health standards and early detection of NCDs through monitoring blood glucose and uric acid levels in the Generasi Kaleb community of the JKI Injil Kerajaan Church, Semarang. The Participatory Health Screening and Education method used includes health education, screening using the Point of Care Testing (POCT) tool, and personal consultation on the results. The service subjects were 50 elderly respondents. The examination results showed a prevalence of abnormal random blood glucose (GDS) of 8%, 32%, had high uric acid levels with a maximum value of 10.3 mg/dL. This activity successfully transformed the elderly's awareness from subjective perception to awareness based on objective data, and encouraged community independence in managing a healthy lifestyle to prevent further NCD complications. .

Background: Hepatocellular Carcinoma (HCC) is an abnormal cell growth in the liver characterized by increased number of dividing liver cells accompanied by malignant transformation. A common paraneoplastic phenomenon in HCC patients is hypoglycemia, which arises due to hepatic dysfunction impairing gluconeogenesis and glycogenolysis, as well as tumor-mediated IGF-II production. This condition causes hypoglycemia as a primary nursing problem requiring comprehensive nursing care. Objective: To describe the nursing care process for a patient with HCC focusing on blood glucose instability management and knowledge deficit intervention. Methods: This study used a descriptive qualitative method through a case study approach. Data were collected through interview, observation, documentation study, and literature review. Results: Two nursing diagnoses were identified: blood glucose instability related to hepatic dysfunction and knowledge deficit related to lack of information exposure. Nursing interventions performed included hypoglycemia management and disease process education. After 2x24 hours of nursing implementation, both diagnoses were partially resolved, as GDS values remained fluctuating and behavioral change had not been fully achieved. Conclusion: Comprehensive nursing management through routine blood glucose monitoring, dextrose administration, nutritional modification, and health education can improve blood glucose stability and patient knowledge in HCC patients.

Background: Community nursing is a service process that is a combination of nursing and public health. Family nursing care is health services focused on the family where the entire process from assessment, diagnosis, planning, implementation to evaluation involves all family members both in healthy and sick conditions. The elderly are individuals in the age range of 60 years and above. Stroke is a disorder of brain function that appears suddenly accompanied by clinical signs both local and global in nature that last more than 24 hours caused by disruption of blood flow to the brain. Objective: To provide family nursing care to Tn. W with Neurological System Disorders: Stroke in Karangjati Village RT 02 RW 05 Tonjong District, Brebes Regency. Methods: This scientific paper is compiled using a descriptive narrative study approach following the stages of the nursing process including assessment, diagnosis, intervention, implementation, and evaluation. Data collection techniques include interviews, observation, physical examination, and documentation studies. Results: Nursing diagnoses that emerged were physical mobility impairment and knowledge deficit. Nursing interventions for physical mobility impairment included recognizing health problems and understanding stroke management, particularly related to mobilization through passive and active range of motion (ROM) exercises. For knowledge deficit, interventions included health education about stroke using educational media. Conclusion: After implementation over three days (December 27–29, 2025), the physical mobility impairment problem was partially resolved and knowledge deficit was resolved. It is expected that patients can increase their knowledge about health, particularly stroke disease.  

Introduction: Congestive Heart Failure (CHF) is a complex clinical syndrome caused by the inability of the heart to pump blood adequately to meet the body's metabolic demands. This condition may result in dyspnea, edema, activity intolerance, fatigue, and reduced quality of life. Comprehensive nursing care is essential to address patients' needs and improve health outcomes. Methods: This study employed a descriptive case study approach. Data were collected through interviews, observation, physical examination, and medical record review. Nursing care was provided using the nursing process, including assessment, nursing diagnosis, planning, implementation, and evaluation. Results: The assessment of Mrs. T identified four nursing diagnoses: ineffective breathing pattern, hypervolemia, activity intolerance, and knowledge deficit. Nursing interventions included semi-Fowler positioning, fluid balance monitoring, passive Range of Motion (ROM) exercises, and health education. Following two days of nursing implementation, three nursing diagnoses were resolved, namely ineffective breathing pattern, activity intolerance, and knowledge deficit. Hypervolemia was partially resolved due to persistent fluid imbalance. Discussion: The findings indicate that the application of systematic nursing care can improve several clinical problems experienced by CHF patients. However, fluid balance management remains a challenge, highlighting the importance of patient adherence to fluid restriction and continuous monitoring to prevent worsening symptoms.

Intracerebral hemorrhage (ICH) is the most common type of hemorrhhagic stroke and a leading cause of death and disability in Indonesia. The prevalence of stroke in Indonesia reached 0.83% in 2023, with ICH cases at RSUD dr. Soeselo, Tegal Regency recording 203 cases in 2024 and increasing significantly to 304 cases in 2025. This study aims to describe comprehensive nursing care for a patient with Intracerebral Hemorrhage. The method used was descriptive narrative through a nursing process approach. Nursing assessment of Ny. S (73 years old) revealed subjective data including headache, nausea and vomiting, and weakness in the left hand and foot, while objective data showed blood pressure 180/80 mmHg, MAP 113.3 mmHg, muscle strength of left extremities 2/2, and CT scan results showing a hyperdense lesion (volume 17.17 cc) with perifocal edema in the right thalamus and right corona, partially filling the ventricular system. Four nursing diagnoses were established: decreased intracranial adaptive capacity related to cerebral edema, impaired physical mobility related to decreased muscle strength, knowledge deficit related to lack of information exposure, and risk of falls. Nursing interventions included intracranial pressure management, mobilization support, health education, and fall prevention. After three days of nursing implementation, three nursing diagnoses were resolved, while impaired physical mobility was partially resolved, resulting in discharge planning recommendations including ROM exercises, gradual mobilization, and family involvement in patient care.

Background: Non-communicable diseases (NCDs) are a major global public health concern, with hypertension affecting an estimated 1.4 billion adults worldwide. In Indonesia, the prevalence of hypertension among individuals aged 18 years and above reached 30.8% in 2023. In Kecamatan Tonjong, Kabupaten Brebes, the number of hypertension sufferers aged 15 years and above reached 15,951 people in 2025. Objective: To implement comprehensive family nursing care for Ny. S, family of Tn. F, who experienced cardiovascular system disorders due to hypertension in Desa Karang Jati RT 01 RW 05, Kecamatan Tonjong, Kabupaten Brebes. Method: This study used a descriptive narrative method with a nursing process approach (assessment, diagnosis, intervention, implementation, and evaluation), conducted through home visits over three days from December 26–28, 2025. Data were collected through interviews, observation, physical examination, and documentation. Results: Two nursing diagnoses were identified: acute pain related to hypertension and knowledge deficit regarding hypertension. Nursing interventions included pain management, oral medication administration (captopril 25 mg), and health education. Complementary non-pharmacological therapy using cucumber juice was applied once daily for three days. Conclusion: After three days of nursing implementation, both nursing diagnoses were fully resolved. Blood pressure decreased from 165/90 mmHg to 132/77 mmHg and the pain scale reduced from 4 to 1. Discharge planning was provided including recommendations for routine blood pressure monitoring, healthy lifestyle, and consistent medication adherence.

Congestive Heart Failure (CHF) is a condition in which the heart is unable to pump blood adequately to meet the metabolic needs of the body. CHF is one of the most prevalent cardiovascular disorders globally, nationally, and locally, contributing to significant morbidity and mortality. This study aims to describe a comprehensive nursing care process applied to a patient (Mr. R) diagnosed with CHF at the Mawar 1 Ward of RSUD dr. Soeselo, Tegal Regency. This study used a descriptive case study design. Data were collected through interviews, physical examination, observation, and medical record documentation on February 9–11, 2026. Three nursing diagnoses were identified: ineffective airway clearance related to airway hypersecretion, fatigue related to physiological conditions (chronic disease), and knowledge deficit related to insufficient information exposure. Nursing interventions applied included airway management (semi-Fowler positioning, oxygen therapy, effective coughing technique), energy management (range-of-motion exercise, gradual activity), and health education about CHF. After 2×24 hours of nursing care, all three nursing diagnoses were resolved: airway clearance improved (SpO₂ increased from 91% to 95%, respiratory rate decreased from 28 to 23 times/minute), fatigue decreased, and patient knowledge about CHF improved. Systematic nursing care significantly improved the patient's condition in CHF management.

Background: Distal radius fracture is the most common fracture of the radius bone near the wrist joint. The prevalence of fractures in Indonesia in 2024 was 3.8%, indicating that approximately 20 million people experienced fractures. Therefore, nursing care planning is required to address musculoskeletal disorders. Objective: To describe the nursing care for patients with Musculoskeletal System Disorders: Post-Op ORIF Fracture of One-Third Distal Radius Dextra. Method: This study used a descriptive narrative method by providing an overview of nursing care through a nursing process approach. Results: Nursing diagnoses that emerged in the patient included acute pain, impaired physical mobility, risk of infection, and knowledge deficit. Interventions performed included pain management, mobilization support, infection prevention, and health education. Conclusion: After two days of nursing implementation, one diagnosis was fully resolved and three diagnoses were partially resolved due to time constraints. Discharge planning was provided including deep breathing relaxation techniques, passive ROM exercises, and wound dressing changes every two days.  

Background: Acute pharyngitis is an inflammation of the pharynx caused by viral or bacterial infections, frequently resulting in sore throat, fever, and dysphagia. This condition is among the most prevalent acute respiratory tract infections in children and adolescents worldwide, contributing significantly to morbidity and the burden of healthcare services. Objective: This case study aimed to describe the comprehensive nursing care provided to patient An. F with acute pharyngitis at Ward Anggrek 1, RSUD dr. Soeselo, Tegal Regency. Methods: A descriptive study design with a nursing process approach was employed. Data were collected through anamnesis, physical examination, observation, and documentation review. The nursing process encompassed assessment, nursing diagnosis, intervention planning, implementation, and evaluation. Results: Assessment revealed chief complaints of throat pain (NRS scale 5), fever (38.8°C), erythematous tonsils, and nutritional deficit. Three nursing diagnoses were established: acute pain related to physiological injury, hyperthermia related to disease process, and knowledge deficit related to insufficient information exposure. Interventions included pain management, hyperthermia management, and health education. Following two days of nursing care, the patient’s condition significantly improved, with pain scale reduced from 5 to 3 and body temperature normalized to 37.7°C. Conclusion: Comprehensive nursing care incorporating pharmacological and non-pharmacological approaches effectively reduced pain and fever, and improved patient and family health literacy regarding acute pharyngitis.

Diabetes Mellitus Type II is a chronic metabolic disease characterized by elevated blood glucose levels due to insulin resistance and impaired insulin secretion. Globally, the number of people with diabetes in 2024 is estimated to reach 800 million, with more than 95% being Type II Diabetes Mellitus. At RSUD Prof. M. Yamin, SH Pariaman in 2025, there were 189 recorded cases of Type II Diabetes Mellitus without complications. The purpose of this scientific paper is to provide nursing care to a patient with Type II Diabetes Mellitus in the Internal Medicine Ward of RSUD Prof. M. Yamin, SH Pariaman. The method used is a case study with a nursing process approach, including observation, interviews, physical examination, and data collection from medical records. This study was conducted in the internal ward for 5 days, from February 6, 2026 to February 10, 2026, with the subject Mrs. N. The assessment results identified nine nursing problems: unstable blood glucose levels, acute pain, impaired skin/tissue integrity, ineffective peripheral perfusion, impaired physical mobility, sleep pattern disturbance, fatigue, risk of infection, and risk of nutritional deficit. The evaluation after 5 days of nursing care showed that five diagnoses were resolved, namely unstable blood glucose levels, ineffective peripheral perfusion, fatigue, risk of infection, and risk of nutritional deficit. Meanwhile, the other four diagnoses were not fully resolved but showed improvement. It is expected that the patient and family will maintain adherence to a healthy lifestyle, therapy, diet, and regular follow-up in order to prevent complications.

Maternal hypertension remains one of the major contributors to maternal morbidity and mortality in Indonesia and globally. This study aimed to analyze the prevalence, mortality trends, and geographical disparities of maternal hypertension in Indonesia during the 2022–2023 period. The research employed a descriptive design using secondary data obtained from official reports of the Indonesian Ministry of Health, national health surveys, and Maternal Perinatal Death Notification (MPDN) data. Data analysis was conducted descriptively by examining prevalence rates, maternal mortality due to hypertension, regional distribution, and temporal trends across provinces in Indonesia. The findings showed a slight but consistent decline in both the prevalence and mortality rates of maternal hypertension from 2022 to 2023 in most provinces. However, significant regional disparities remained evident. Provinces in eastern Indonesia, including Papua Barat, Nusa Tenggara Timur, Maluku, and several provinces in Sulawesi and Kalimantan, consistently recorded higher prevalence and mortality rates compared to provinces in Java and Bali. Meanwhile, provinces with better healthcare infrastructure and maternal referral systems demonstrated lower mortality outcomes. The study also revealed a strong association between high prevalence and increased maternal mortality, indicating the importance of healthcare accessibility, antenatal care quality, and emergency obstetric services in reducing maternal health burdens. These findings emphasize the need for region-specific maternal health interventions, improved healthcare distribution, early detection programs, and strengthened referral systems to reduce maternal hypertension disparities and improve maternal health outcomes in Indonesia.

Diarrhea has the potential to cause an Extraordinary Event (KLB) and is currently a leading cause of mortality in Indonesia, especially in children. Antibiotics are necessary for diarrhea caused by bacteria, but irrational antibiotic prescribing can increase the risk of antibiotic resistance. This literature review was conducted to provide an overview of the level of rationality of antibiotic use in pediatric patients with diarrhea in several Indonesian health facilities. The literature review was conducted by reviewing articles obtained through a Google Scholar search using the keywords "rationality of antibiotic use," "diarrhea," "children," and "evaluation of antibiotic use." Articles were selected using inclusion and exclusion criteria, resulting in 10 suitable articles. The study results indicate that the evaluation methods for antibiotic use include the Gyssens criteria, World Health Organization criteria, Ministry of Health Decree Standards, the 2012 World Gastroenterology Organization Guidelines, and the Rational Drug Use Module. Commonly used evaluation parameters include appropriate indication, appropriate drug, appropriate dose, and appropriate patient. Most parameters have obtained rational results, but there are several studies that are not rational in the appropriate indication, appropriate drug, and appropriate dose categories. Variations in the results of rational antibiotic use at each health facility are influenced by patient characteristics, policies at the health care facility, and the level of compliance of health workers with therapy guidelines.

Diarrhea has the potential to cause an Extraordinary Event (KLB) and is currently a leading cause of mortality in Indonesia, especially in children. Antibiotics are necessary for diarrhea caused by bacteria, but irrational antibiotic prescribing can increase the risk of antibiotic resistance. This literature review was conducted to provide an overview of the level of rationality of antibiotic use in pediatric patients with diarrhea in several Indonesian health facilities. The literature review was conducted by reviewing articles obtained through a Google Scholar search using the keywords "rationality of antibiotic use," "diarrhea," "children," and "evaluation of antibiotic use." Articles were selected using inclusion and exclusion criteria, resulting in 10 suitable articles. The study results indicate that the evaluation methods for antibiotic use include the Gyssens criteria, World Health Organization criteria, Ministry of Health Decree Standards, the 2012 World Gastroenterology Organization Guidelines, and the Rational Drug Use Module. Commonly used evaluation parameters include appropriate indication, appropriate drug, appropriate dose, and appropriate patient. Most parameters have obtained rational results, but there are several studies that are not rational in the appropriate indication, appropriate drug, and appropriate dose categories. Variations in the results of rational antibiotic use at each health facility are influenced by patient characteristics, policies at the health care facility, and the level of compliance of health workers with therapy guidelines.