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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: Congestive Heart Failure (CHF) is a condition characterized by the inability of the heart to pump blood optimally, resulting in the accumulation of fluid in the lungs and other organs. This condition frequently causes ineffective airway clearance due to hypersecretion of the airway. Objective: This study aims to describe the comprehensive nursing care provided to Ny. R with Cardiovascular System Disorder: Congestive Heart Failure (CHF) with the main nursing problem of ineffective airway clearance at the Melati Ward of RSUD Banyumas. Method: This study used a descriptive method through a case study approach. Data were collected through interviews, physical examination, observation, and documentation. Results: Two nursing diagnoses were identified: (1) ineffective airway clearance related to airway hypersecretion, and (2) activity intolerance related to an imbalance between oxygen supply and demand. Nursing interventions included airway management and energy management. After two days of implementation (January 27–28, 2026), the first diagnosis was resolved and the second was partially resolved, with continued interventions recommended including monitoring of physical and emotional fatigue, advising bed rest, and monitoring vital signs. Conclusion: Comprehensive nursing care with appropriate interventions can effectively address ineffective airway clearance in CHF patients.

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.

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.

Knee septic arthritis is an orthopedic emergency that requires prompt and appropriate management to prevent permanent joint damage and systemic complications. Inflammatory markers such as erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) are commonly used for diagnosis and monitoring of treatment response; however, their prognostic value after surgical debridement remains variable. This systematic review aimed to evaluate the role of ESR, CRP, and platelet count as prognostic indicators following irrigation and/or surgical debridement in patients with knee septic arthritis. A literature search was conducted in January using PubMed, Google Scholar, ScienceDirect, Wiley Online Library, SpringerLink, and Semantic Scholar, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Study quality was assessed using the National Heart, Lung, and Blood Institute (NHLBI) tools. Fifteen studies meeting the inclusion criteria were qualitatively analyzed. The findings indicate that elevated preoperative CRP levels and delayed postoperative CRP reduction are associated with unfavorable clinical outcomes, including failure of infection eradication and the need for repeat debridement. Although ESR is consistently elevated during the acute phase, its slower decline limits its short-term prognostic utility. Platelet count may increase as part of the systemic inflammatory response but shows inconsistent prognostic value.

Hypertension is a chronic condition characterized by systolic blood pressure >130 mmHg and diastolic >80 mmHg, which can lead to serious complications such as stroke and heart failure if left unmanaged. This study aims to describe the application of warm water foot soak intervention in reducing blood pressure among hypertensive patients in the Dongkelan Kauman area. This was a descriptive study with a case study approach involving three elderlies with hypertension. The intervention was conducted for 20 minutes daily using warm water at a temperature of 38-40°C for three consecutive days. Data were collected through interviews and blood pressure measurements using a tensimeter before and after the intervention. The results showed a decrease in blood pressure in all three subjects after routinely implementing the intervention. The highest systolic reduction reached 15 mmHg, while the average diastolic reduction was 5 mmHg. Physiologically, warm water stimulates blood vessel vasodilation, which facilitates blood flow and reduces muscle tension. The study concludes that warm water foot soak therapy potentially effective as a non-pharmacological complementary intervention for controlling blood pressure in elderly patients with hypertension.

Hypertension is a chronic condition characterized by systolic blood pressure >130 mmHg and diastolic >80 mmHg, which can lead to serious complications such as stroke and heart failure if left unmanaged. This study aims to describe the application of warm water foot soak intervention in reducing blood pressure among hypertensive patients in the Dongkelan Kauman area. This was a descriptive study with a case study approach involving three elderlies with hypertension. The intervention was conducted for 20 minutes daily using warm water at a temperature of 38-40°C for three consecutive days. Data were collected through interviews and blood pressure measurements using a tensimeter before and after the intervention. The results showed a decrease in blood pressure in all three subjects after routinely implementing the intervention. The highest systolic reduction reached 15 mmHg, while the average diastolic reduction was 5 mmHg. Physiologically, warm water stimulates blood vessel vasodilation, which facilitates blood flow and reduces muscle tension. The study concludes that warm water foot soak therapy potentially effective as a non-pharmacological complementary intervention for controlling blood pressure in elderly patients with hypertension.

Heart failure is a clinical syndrome characterized by shortness of breath and fatigue resulting from structural or functional abnormalities of the heart.  Acute Decompensated Heart Failure (ADHF), also known as decompensated heart failure, is a condition of worsening chronic heart failure that can occur acutely, subacutely, or insidiously, with symptoms progressively worsening over several days or weeks. A 1-year-old male patient presented to the Dermatology Clinic at Cut Meutia General Hospital with the chief complaint of A 60-year-old female patient was brought to the Cut Meutia Emergency Department with the complaint of shortness of breath that had worsened 1 day prior to admission; the shortness of breath worsened during light activity and when the patient was lying down. She also complained of swelling in both legs for one week prior to admission, which had progressively worsened. On examination, skin turgor was slow to return in the left and right lower extremities; palpation of the neck revealed jugular vein distension. Inspection showed a normal chest contour; auscultation of the lungs revealed rhonchi. Cardiac percussion revealed enlargement of the upper, left, and right borders of the heart, as well as the cardiac border at the level of the waist. Auscultation revealed a murmur at the fourth intercostal space on the left side. Examination of the lower extremities revealed pitting edema on both the left and right sides.  Supportive X-ray examination revealed severe cardiomegaly. An ECG revealed sinus rhythm, an irregular rate of 80 beats per minute, LAD axis, P wave not identifiable, PR interval 0.20 seconds, QRS complex 0.6 seconds, inverted T waves in I and AVL, LVH (+), RVH (-), PVCs, AF, and lateral ischemia. Echocardiography revealed severe aortic stenosis due to RHD and an LVEF of 21%. The patient has been prescribed furosemide, warfarin, bisoprolol, and spironolactone.

Congestive heart failure (CHF) is a cardiovascular disease that frequently causes shortness of breath (dyspnea) and negatively impacts patients’ quality of life. The management of dyspnea involves not only pharmacological approaches but also nonpharmacological interventions, one of which is handheld fan therapy, which works by stimulating sensory receptors in the facial area. This study aims to describe the effect of handheld fan therapy on reducing shortness of breath in patients with CHF. This study employed a descriptive design using a case report method on a single 63-year-old female patient diagnosed with CHF. The intervention was conducted over four days, involving the use of a handheld fan for 10 minutes, held at a distance of 15–30 cm from the face and directed toward the nose and mouth. Measurements were taken before and after the intervention using respiratory rate and oxygen saturation as parameters. The results showed a gradual decrease in respiratory rate from 24 breaths/minute to 18 breaths/minute, as well as an increase in oxygen saturation from 91% to 96% during the intervention period. These findings indicate an improvement in breathing patterns and increased respiratory efficiency in the patient. Handheld fan therapy is effective as a nonpharmacological intervention for reducing shortness of breath and improving oxygenation in patients with CHF. This intervention is safe, easy to use, and can be implemented as a complementary therapy in nursing practice.

Hypertension has become a chronic disease known as the silent killer because it often does not show symptoms but can cause serious complications such as stroke, heart disease, and kidney failure. According to WHO, hypertension is one of the leading causes of death worldwide and its prevalence continues to rise. Sleep disturbances can increase sympathetic nervous system activity and stress hormones, which impact blood pressure elevation. Depression is characterized by prolonged feelings of sadness, loss of interest, and decreased energy. Physiologically, depression can increase stress hormones and cause autonomic nervous system imbalance, leading to elevated blood pressure. To determine the relationship between sleep pattern disturbances and depression levels with blood pressure in hypertensive patients in the outpatient department of RS Permata Medika Semarang. Quantitative research with a correlational design using a cross-sectional approach. The sampling technique used was consecutive sampling with a sample size of 79 respondents. The instruments used are the PSQI questionnaire for sleep pattern disturbances and the DASS-42 for depression levels. Ethics test no 03/EC-LPPM/UWHS/II-2026. Data analysis used the Spearman Rank test. The research results show that there is a significant relationship between sleep pattern disturbances and blood pressure in hypertensive patients (p=0.000; rho=0.826). Respondents with poor sleep patterns mostly have high blood pressure, indicating a very strong and positive relationship, where the worse the sleep pattern, the more uncontrolled the blood pressure tends to be. Additionally, there is a significant relationship between the level of depression and blood pressure (p=0.000; rho=0.808). Respondents with severe and very severe depression mostly have high blood pressure, which means that the higher the level of depression, the more the blood pressure increases or becomes uncontrolled. There is a relationship between sleep pattern disturbances and depression levels with blood pressure in hypertensive patients in the outpatient department of Permata Medika Hospital Semarang.

Cardiovascular dysfunction is a disorder of the blood vessels, such as hypertension, heart failure, and stroke. In 2016, cardiovascular disease was the leading cause of death worldwide, based on data from the World Health Organization (WHO). Coronary Heart Disease (CHD) is the leading cause of death, along with stroke, as shown by the Sample Registration System survey in 2014.This case involves a 64-year-old male, Mr. N, who presented to the emergency department of RSUD dr. Fauziah Bireuen with complaints of chest pain that developed gradually and worsened over the past month. The pain was located across the entire chest and radiated to the back and neck. The pain was described as severe, like being crushed by a heavy load, worsened during strenuous activities such as cutting grass and chopping wood, and relieved when the patient bent forward. The pain could occur at any time, with a Visual Analog Scale (VAS) score of 10 (severe pain). The patient also reported easy fatigue during heavy physical activity over the past month. Laboratory examination revealed elevated leukocytes, mean corpuscular volume (MCV), segmented neutrophils, troponin I, cholesterol, and triglycerides. The patient was diagnosed with extensive anterior ST-elevation myocardial infarction (STEMI) post successful fibrinolytic therapy.

Hypertension contributes to numerous complications such as heart disease, stroke, kidney failure, and is a risk factor of disability and death. Hypertension Prevalence in Jatinangor is 37.8%, that is higher than national rate. The control of hypertension is low and the education at the primary health facility is short. Therefore, another buffer system for education such as posbindu is needed. Activities that educate people with hypertension become very important, but need to be adjusted as needs. Aim of this study is to determine form and intensity of education preferred by hypertension patients Method: Qualitative descriptive with case study approach using focused group discussion (FGD) method, led by main moderator and assisted by a second moderator. Participants consisted of 15 people with hypertension chosen purposively with the inclusion criterias female and parallel to the research objective. The discussion used semi-structured questions. This study is conducted in two villages in Jatinangor, Desa Cipacing and Desa Cilayung from February to May 2017. Results: Participants wanted education in the form of traditional learning, game simulation, written notes, and video recording. The intensity of education preferred until patients understand, it tends to be performed more than once, and preferred place are performed within Posyandu (Integrated Health and Nutrition Post) with education frequency varies from once a week to once a month. Conclusion: Hypertension patients have variable preference of education forms and its intensity. Innovations in the development of methods in accordance with hypertension patients’ needs must be continued, so that interventions can become more effective for hypertension patients.

Diuretic resistance is a serious complication in heart failure patients associated with increased morbidity and mortality. Tolvaptan, a vasopressin V2 receptor antagonist, offers an alternative therapeutic mechanism through aquaresis. This study aims to evaluate the effectiveness and safety of tolvaptan in heart failure patients with diuretic resistance. A retrospective cohort study was conducted on 58 hospitalized patients with NYHA III-IV heart failure and diuretic resistance (urine output <1000 mL/day despite furosemide use ≥80 mg/day) who received tolvaptan 7.5-15 mg/day for 7 days. Variables measured included weight change, urine output, serum sodium, and kidney function. The results showed a significant increase in daily urine output from 820±230 mL to 2180±520 mL (p<0.001), along with an average weight loss of 3.4±1.1 kg (p<0.001). Hypernatremia (>145 mEq/L) occurred in 8.6% of patients. In conclusion, tolvaptan is effective in improving diuresis and reducing congestion in heart failure patients with diuretic resistance, although the risk of hypernatremia should be monitored.

Hypertension in the elderly requires long-term treatment to prevent cardiovascular consequences. Adherence to antihypertensive medication is crucial for blood pressure management. Adherence to antihypertensive medication is a crucial aspect in hypertension management. Poor adherence can lead to uncontrolled blood pressure, thereby increasing the risk of cardiovascular problems, including stroke, myocardial infarction, and heart failure. This study aims to determine the correlation between adherence to antihypertensive medication and blood pressure in the elderly at the Ronggo Husada Primary Inpatient Clinic in Malang. This study used a cross-sectional design. The cohort consisted of 52 geriatric patients with hypertension who consistently visited the Ronggo Husada Primary Inpatient Clinic in Malang. The sample consisted of 40 patients. The sampling method used was purposive sampling. Research factors included medication adherence and blood pressure. Data collection was conducted through a questionnaire. This study was conducted at the Ronggo Husada Primary Inpatient Clinic in Malang on November 6, 2025. Data processing used the Chi-square test. The analysis included univariate and bivariate analyses, using the Chi-square test. The results showed that more than 50% of elderly participants demonstrated moderate adherence to antihypertensive medication (18 individuals (45%). Nearly 50% of elderly participants suffered from stage I hypertension (14 individuals (35%), and stage II hypertension (11 individuals (27.5%). Statistical analysis using the Chi-square test showed a significant correlation between adherence to antihypertensive medication and blood pressure in the elderly, with a p-value of 0.000, which is below the alpha threshold of 0.05 (5%). Elderly individuals who demonstrated strong adherence had better blood pressure regulation compared to those with poor adherence. These results emphasize the importance of adherence to therapy in the management of hypertension in the elderly.    

Hypertension is a highly prevalent non-communicable disease often referred to as "The Silent Killer" because it rarely shows symptoms until it causes serious complications such as stroke, kidney failure, and heart disease. This community service activity aims to optimize the Mobile Blood Pressure Monitoring Program as a hypertension screening method in Sanahu Village. The methods used include participant data collection, blood pressure checks with a manual sphygmomanometer, and health education on hypertension prevention. A total of 96 participants participated in this activity, and the results showed that 58 participants (60.4%) were hypertensive. This program has proven effective in reaching communities with limited access to health services and raising public awareness about the importance of early detection of non-communicable diseases. In addition, this activity succeeded in providing knowledge to the community about how to prevent hypertension and the importance of maintaining a healthy lifestyle, which is expected to reduce the incidence of hypertension in the future.

Pasien CHF sering mengalami intoleransi aktivitas akibat kelelahan dan sesak napas. Salah satu intervensi untuk mengatasi masalah tersebut adalah mobilisasi dini. Tujuan penerapan mobilisasi dini ini adalah untuk menganalisis efektifitas mobilisasi dini terhadap tekanan darah, denyut nadi dan saturasi oksigen. Metode penelitian ini menggunakan Studi Kasus. Jumlah responden penerapan ini berjumlah 2 pasien terbagi menjadi pasien intervensi dan pasien kontrol. Hasil penerapan menunjukkan setelah dilakukan mobilisasi dini kepada pasien intervensi didapatkan peningkatan tekanan sistolik sebesar 10 mmHg dan diastolik sebesar 10 mmHg. Sedangkan pasien kontrol terjadi peningkatan tekanan sistolik sebesar 10 mmHg, namun tekanan diastolik tetap. Denyut nadi pada pasien intervensi mengalami peningkatan 18x/menit. Sedangkan pasien kontrol terjadi peningkatan 23x/menit. Saturasi oksigen pada pasien intervensi mengalami kenaikan 5% dan pasien kontrol tidak mengalami kenaikan pada saturasi oksigen. Jadi dapat disimpulkan dari penerapan ini bahwa ada pengaruh mobilisasi dini terhadap tekanan darah, denyut nadi dan saturasi oksigen di ruangan krisan RSUD Arifin Achmad. Disarankan kepada perawat dan pihak rumah sakit agar tetap dapat mengembangkan penerapan mobilisasi dini menjadikan intervensi ini sebagai rujukan asuhan keperawatan dalam mengendalikan status hemodinamik.  

Hypertension substantially increases the risk of developing secondary conditions, including stroke, renal disease, coronary heart disease, and heart failure. Early management is therefore essential to prevent complications and adverse outcomes. Evidence indicates that untreated hypertension contributes to approximately 60% of stroke cases. Public knowledge regarding hypertension-related complications remains limited, and many individuals are unable to identify early signs of stroke the most common complication associated with hypertension. This study aimed to assess the knowledge of hypertensive patients regarding stroke risk and management at Santa Elisabeth Hospital Medan in 2024. A descriptive research design was employed. The sample consisted of 67 hypertensive patients attending the outpatient clinic, selected through purposive sampling. Data were presented using frequency distribution tables. The findings revealed that 52.2% of respondents demonstrated poor knowledge, 32.8% had moderate knowledge, and only 14.9% showed good knowledge regarding stroke risk and management. These results underscore the need for patients to adopt healthier lifestyles and for the hospital to strengthen educational efforts by providing more engaging and interactive learning materials for patients and their families.

Diabetes mellitus (DM) is a metabolic disease characterized by elevated blood glucose levels. This condition includes several types, such as type 1 and type 2 diabetes. It occurs when the body is unable to produce enough insulin, experiences impaired insulin function, or faces a combination of both. As a result, glucose cannot be effectively absorbed by the body’s cells and accumulates in the bloodstream, leading to high blood sugar or hyperglycemia. If this condition persists, the buildup of glucose can cause various disorders in different organs. Without proper management, diabetes may lead to severe and life-threatening complications. Chronic hyperglycemia in diabetic patients is associated with long-term damage, dysfunction, and even failure of vital organs such as the eyes, kidneys, nerves, heart, and blood vessels. In this activity, percentage-based methods and demonstrations of blood glucose testing were used as educational tools for students. The results showed that students’ awareness of the dangers of elevated blood sugar levels remains low. Many of them are still unfamiliar with the importance of regular blood glucose monitoring and maintaining a healthy lifestyle to prevent diabetes. Therefore, continuous efforts are needed to provide education and outreach on the prevention and early management of diabetes mellitus.

The prevalence of hypertension in the elderly continues to increase and is a major cause of morbidity and mortality. Uncontrolled blood pressure can lead to serious complications such as heart disease, stroke, and kidney failure. Anxiety, which is often experienced by the elderly, also plays a role in worsening hypertension through activation of the sympathetic nervous system and increased stress hormones. This study aims to determine the relationship between anxiety levels and the incidence of hypertension in the elderly at the Kuta Alam Community Health Center in Banda Aceh City. The study used a quantitative method with a cross-sectional analytical design. The study population consisted of 145 elderly people with hypertension, with a sample of 59 people selected through a purposive sampling technique. The study was conducted from April 28 to May 8, 2025. Anxiety levels were measured using the Geriatric Anxiety Inventory (GAI) questionnaire, and blood pressure was measured using a digital sphygmomanometer. Data analysis was carried out univariately and bivariately using the Chi-square test. The results showed that the majority of respondents experienced panic anxiety (39.0%) and Grade III hypertension (44.1%). There was a significant relationship between anxiety levels and the incidence of hypertension in the elderly (ρ = 0.000; ρ < 0.05). In conclusion, anxiety influences the severity of hypertension, so psychological aspects need to be considered in elderly health services at the Kuta Alam Community Health Center.

Hypertension is one of the most common diseases experienced by the community and poses a high risk of causing serious complications. Persistently elevated blood pressure can damage vital organs and increase the risk of cardiovascular diseases such as heart attacks, strokes and kidney failure. The purpose of this study is to determine the implementation of foot reflexology massage to reduce blood pressure in patients with hypertension. This research employed a case study approach involving two hypertensive patients at TK II Putri Hijau Hospital Medan. The Nursing care process included assessment, nursing diagnosis, planning, implementation, and evaluation. The results showed a decrease in both systolic and diatolic blod pressure after the foot reflexology intervention. The first patient experienced a reduction in blood pressure from 145/90 mmHg to 130/82 mmHg, while the second patient’s blood pressure from 144/89 mmHg to 128/82 mmHg. The study cocludes that the implementation of foot reflexology massage is proven to be efeective in lowering blood pressure in hypertensive patients. This therapy is recommended as a complementary intervention in nursing practice to assist in controlling hypertension.