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Fracture is a condition characterized by the disruption of bone continuity that often causes acute pain, especially in patients following Open Reduction and Internal Fixation (ORIF). Effective pain management is essential to support the recovery process and improve patient comfort during hospitalization. This study aimed to determine the effectiveness of cold compress therapy (cryotherapy) in reducing pain intensity in post-ORIF patients. This study used a case study method on a patient diagnosed with a right humerus fracture at PKU Muhammadiyah Bantul Hospital. Data were collected through interviews, interventions, and documentation using the PQRST method. Cryotherapy was administered once daily for three consecutive days using an ice bag applied to the painful area. The results showed a gradual decrease in pain intensity from scale 7 to 6 on the first day, 5 on the second day, and 4 on the third day. The patient also reported increased comfort after the intervention. These findings indicate that cryotherapy is effective as a non-pharmacological intervention in reducing postoperative pain and improving patient comfort.

A Normocytic normochromic anemia is one of the most common types of anemia found in geriatric patients with chronic diseases or acute bleeding. Upper gastrointestinal bleeding (UGIB) may cause continuous blood loss resulting in decreased hemoglobin levels. This case report discusses a 72-year-old woman who presented to the Emergency Department of Cut Meutia Regional General Hospital with complaints of black stools for four days prior to admission accompanied by epigastric pain, nausea, weakness, and pallor. The patient had a history of long-term use of analgesic and anti-gout medications due to chronic joint pain, which was suspected to be a risk factor for UGIB. Physical examination revealed pale conjunctiva and tachycardia, while laboratory findings showed hemoglobin of 7.1 g/dL, hematocrit of 23.3%, MCV of 82 fL, MCH of 29 pg, and uric acid level of 11.56 mg/dL, leading to the diagnosis of normocytic normochromic anemia caused by UGIB accompanied by gout arthritis. The patient received intravenous fluid therapy, proton pump inhibitors, antifibrinolytic agents, gastroprotective therapy, packed red cell transfusion, and other supportive treatments. During hospitalization, clinical improvement was observed, including cessation of gastrointestinal bleeding, reduced epigastric pain, and increased hemoglobin level to 8.6 g/dL. This case highlights the importance of early diagnosis and comprehensive management in geriatric patients with anemia caused by UGIB and comorbid gout arthritis.

Pneumonia caused by extensively drug-resistant (XDR) Pseudomonas aeruginosa is still  clinicaly chalenging, particularly among geriatric patients with neurological comorbidities such as stroke. This report presents a case of XDR P. aeruginosa pneumonia complicated by sepsis in a 73-year-old patient, characterized by persistent leukocytosis until the tenth day of hospitalization despite empirical meropenem therapy. This evidence-based case report aims to analyze clinical outcomes, specifically 28-day and 30-day mortality rates, and to identify mortality predictors in the adult population through a systematic literature search of the PubMed and Google Scholar databases for the 2019–2026 period. Synthesized evidence from six core studies indicates that XDR P. aeruginosa infections carry a profoundly high 28-day mortality rate, ranging from 41% to 51% in cohorts receiving antibiotic monotherapy. Key mortality predictors identified include the presence of sepsis or septic shock, a delay in initiating adequate therapy exceeding 52 hours, advanced age, and the requirement for Intensive Care Unit (ICU) admission. The phenomenon of persistent or worsening leukocytosis during treatment, as observed in this case, serves as a critical clinical indicator associated with antimicrobial response failure and a dismal prognosis. Ultimately, XDR P. aeruginosa pneumonia is associated with poor clinical outcomes, where therapeutic success is strictly contingent upon the timely administration of antibiotic regimens with proven activity against these highly resistant isolates.

The quality of nursing services is not solely determined by nurses’ technical competence in providing clinical care, but is also influenced by their ability to establish therapeutic communication with patients. Therapeutic communication is a professional interaction process aimed at helping patients understand their health conditions, express their feelings, and develop a trusting relationship with nurses. Effective communication between nurses and patients can increase patients’ comfort during hospitalization and may influence their level of satisfaction with the nursing services provided. This study aimed to determine the relationship between nurses’ therapeutic communication and patient satisfaction in the inpatient ward of Grha Permata Ibu Hospital in 2025. This study used an observational analytic design with a cross-sectional approach. The sample consisted of 182 patients selected using a purposive sampling technique. Data were collected using a therapeutic communication questionnaire and the Patient Satisfaction with Nursing Care Quality Questionnaire (PSNCQQ) to assess patient satisfaction with nursing care. Data analysis was conducted using the Spearman Rank correlation test to determine the relationship between the two variables. Most respondents assessed nurses’ therapeutic communication as good (87%). However, the majority of patients reported poor satisfaction levels (79.7%). The results of the Spearman Rank analysis showed a Sig. (2-tailed) value of <0.001 with a correlation coefficient of rs = −0.438, indicating a statistically significant relationship with a moderate correlation strength between nurses’ therapeutic communication and patient satisfaction. There is a significant relationship between nurses’ therapeutic communication and patient satisfaction in the inpatient ward of Grha Permata Ibu Hospital.

Hospitalization is a condition that requires a child to be admitted to the hospital. This situation causes children to experience anxiety, restlessness, and fear. One of the nursing interventions to reduce anxiety due to hospitalization is play therapy. A form of play therapy appropriate for preschool children is puzzle play therapy. Puzzle play therapy is an activity in which children arrange pieces of pictures or specific shapes to form a complete image. This therapy encourages children to develop patience, stimulates concentration, and provides feelings of comfort and enjoyment, thereby reducing anxiety. The method used in preparing this Final Nursing Scientific Paper was a descriptive case study with the implementation of puzzle play therapy. The respondents consisted of three children experiencing anxiety due to hospitalization. Puzzle play materials and the Facial Image Scale (FIS) were used as measurement tools. The intervention was conducted over three consecutive days, with a duration of 15 minutes per session. The results showed a decrease in anxiety levels after puzzle play therapy: respondent 1 decreased from anxiety scale 5 to scale 1, respondent 2 from scale 4 to scale 1, and respondent 3 from scale 5 to scale 1. It can be concluded that puzzle play therapy is effective in reducing anxiety due to hospitalization in preschool children with dengue hemorrhagic fever. The implementation of puzzle play therapy is expected to become a routine nursing intervention to reduce hospitalization-related anxiety in preschool children with dengue hemorrhagic fever.

The high cost of colloid fluids and the large number of patients are concerns in determining which treatment standard should be chosen from several treatment alternative, where the total cost for 43 cases with a combination of crystalloid colloid fluids is IDR 209.370.993 while the total cost for 45 cases of crystalloid fluids is only UDR 146.492.268 which causes hospital losses. This study aims to determine the difference in the cost-effectiveness between crystalloid fluids and crystalloid-colloid combinations in hospitalized dengue fever patients without shock at Tangerang City Hospital. The research design used was cross-sectional with a comparative quantitative analysis method, where cost effectiveness was analyzed using the Average Cost Effectiveness Ratios (ACER) method. There were two groups of study samples: the first group, 25 patients who received crystalloid fluids, and the second group, 23 patients who received crystalloid-colloid combination fluids. This study showed a difference in the average hospitalization costs for dengue patients between crystalloid fluid therapy and crystalloid-colloid combination therapy. Hospitalization costs for dengue patients were lower in the crystalloid fluid group, with a significant difference (p=0.000). It was also found that crystalloid fluids were more cost-effective than the crystalloid-colloid combination. The implications of the study results consist of theoretical implications and practical implications. Based on the results of the analysis carried out, the crystalloid solutions are more cost-effective than crystalloid-colloid combinations. This finding can be used as a consideration in making decisions and policies that are in accordance with quality control and cost control for patients covered by the National Health Insurance (BPJS Health insurance).

Nephrotic syndrome (NS) is a kidney disorder characterized by massive proteinuria, hypoalbuminemia, edema, and hypercholesterolemia, most commonly occurring in children. This disease can be caused by various conditions, such as minimal change disease, FSGS, or lupus nephritis. This case report discusses a 16-year-old boy who experienced nephrotic syndrome with symptoms of swelling throughout his body, accompanied by decreased appetite and a productive cough. The patient presented with complaints of swelling throughout his body that began 7 days after hospitalization and was accompanied by coughing and shortness of breath. A physical examination revealed massive edema, abdominal hypertympany, and shifting dullness. Laboratory tests revealed proteinuria, hypoalbuminemia, and decreased serum albumin. Other supporting tests confirmed nephrotic syndrome. The patient received medication therapy including diuretics, corticosteroids in the form of methylprednisolone, and albumin. Nephrotic syndrome in children can develop gradually and requires management that includes steroids, diuretics, and close monitoring of kidney function and electrolytes. Early detection and appropriate treatment can help improve the patient's prognosis.

Long-term treatment adherence is critical for schizophrenia patients, yet non-adherence remains a significant global challenge, contributing to relapse, re-hospitalization, and increased healthcare costs. Understanding the underlying multidimensional factors is crucial for developing effective interventions. This systematic literature review aims to identify and categorize the dominant factors contributing to medication non-adherence among schizophrenia patients, based on current quantitative evidence (2019-2024). A systematic search of Google Scholar and PubMed targeted quantitative cross-sectional studies using the PICOST framework. Article selection followed PRISMA guidelines, and quality was assessed using the JBI Critical Appraisal Checklist. Seven articles were included in the final narrative synthesis. The synthesis confirms that non-adherence is multifactorial. Identified factors were categorized into three groups: (1) Patient-related factors (e.g., poor illness insight, feeling cured, treatment fatigue); (2) Treatment-related factors (e.g., medication side effects, therapy duration); and (3) System and social factors (e.g., low family support, stigma, poor therapeutic alliance). Non-adherence is a complex issue arising from the interplay of patient, treatment, and social factors. Low family support and poor patient knowledge consistently emerge as key determinants. Interventions require a holistic approach extending beyond pharmacotherapy, focusing on comprehensive psychosocial education for patients and families, active side-effect management, and strengthening the family's role in care.