Group 3

Regita Nurmaliantika A
Yusmita Puji L
Naila Rukhil Azizah
Nurmaya Fauztina F
Fatimah Chakim
 CASE
● Case: Mr. Y, 66 years old, was diagnosed with Gangrene DM Type 2 left pedis.
SHORT HISTORY
● Main complaints: Body weakness, nausea and decreased appetite
LONG HISTORY
● One month before he was admitted to the hospital, the patient stepped on a piece of mild steel so that the
sole of his left foot was injured. The wound was not too big, so the blood came out only a little. Because that
is the only wound treated with red medicine and put pressure bandages. A few days later, when the
bandage was removed, a lump appeared on the back of the left leg and the wound on the right foot was
getting wider. Mr Y was accompanied by his family for treatment at the puskesmas. Handling that is done is
to clean the wound. Check blood sugar when showing the result> 200 mg / dL and it is said that the client is
suffering from sugar disease. At the time of the assessment, Mr Y looked weak lying in bed. When he tried
to sit up he complained of dizziness, so he was constantly lying down. When speaking he had difficulty
concentrating, looked sleepy, and occasionally yawned. He complained that it was difficult to sleep. The
mucosa of the lips looks dry, and says food and drinks taste bitter to him, even though he previously ate a
lot and drank a lot because he was easily hungry and thirsty. Today she complained that she could not
defecate, she could not go to the bathroom, so she had to be helped by nurses and her family. Her whole
body feels sore, while the skin on her back, heels, elbows and shoulders aches. After checking, it turns out
that it looks reddish and starts to blister.
1. What are the things that need to be studied further in the patient
regarding the fulfillment of rest and sleep needs 

●Assessment of the patient's sleep history, sleep habits of the patient,

the consequences of the illness (pain scale) from wounds, DM, anemia),
physical examination (glazed eye, tap), vital examination (blood
pressure), patient psychology (whether there is any axietas). 
●Assessment can be through interviews and diagnostic studies
(electroencephalogram (EEG), electromyogram (EMG), Elektrookulogram
(EOG) 
2. What causes problems in meeting the needs of rest and sleep
experienced by the patient?

● Patient comfort (habits, pain scale, lifestyle, environment)

● Interference with the fulfillment of rest and sleep needs, due to sources energy
decreases so that the patient complains of weakness, besides frequency BAK at
night causes the patient to experience disturbances in the pattern of sleep.
Impaired skin integrity, caused by decreasing it or not the presence of sensation
due to neuropathy, decreased tissue function as a result cardiovascular
complications and infections. Interruption of fulfillment of needs activity, because
the patient has decreased muscle strength and wounds that are difficult to heal.
These disturbances if not immediately handled will cause complications from DM
disease
3. What factors affect the fulfillment of rest and sleep needs

● Influencing factors
● Illness (injury, dm) and medical history, mental condition (whether
anxiety, fatigue), environment (how to support patient comfort), lifestyle
and patient habits
4. What nursing interventions are appropriate to address rest and sleep
problems.

• Change the patient's position to make it comfortable

• Set visiting hours
• Giving therapy (e.g. music)
• Pay attention to feeding
• Provide education about sleep patterns
• Increase activity during the day
• Providing sleeping pills (CTM, triazolam, etc)
THANK YOU!
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