Case Study: Nursing Care for a Patient with CHF and Ineffective Peripheral Perfusion Through Passive Range of Motion (ROM) Interventions for the Lower Extremities Combined with 30° Leg Elevation in the Intensive Cardiac Care Unit (ICCU) at Jakarta Cempaka Putih Islamic Hospital
DOI:
https://doi.org/10.56359/igj.v5i3.1091Keywords:
ABI (Ankle-Brachial Index), CHF (Congestive Heart Failure), Elevation of the Legs, Passive Range of Motion, Ineffective Peripheral PerfusionAbstract
Background & Objective: The high incidence of CHF is inseparable from various etiological factors, one of which is valvular heart disease. Valvular heart disease, whether in the form of stenosis or regurgitation, can lead to disturbances in blood flow and a chronic increase in cardiac workload. In Indonesia, valvular heart disease remains a significant problem, particularly rheumatic heart disease, which is commonly found among individuals in the productive age group. One of the interventions that can be provided is passive ROM (Range of Motion) exercises on the lower extremities combined with 30° leg elevation. This final scientific paper aims to determine the effectiveness of passive ROM exercises on the lower extremities combined with 30° leg elevation in patients with CHF. Method: A case study was conducted using a nursing care approach that included assessment, determination of nursing diagnoses, planning, implementation, and evaluation for a patient with CHF (Mrs. M) who was treated in the ICCU of Jakarta Islamic Hospital Cempaka Putih. The intervention of passive ROM (Range of Motion) exercises on the lower extremities combined with 30° leg elevation was administered once daily for three consecutive days to monitor the patient’s peripheral circulation using the Ankle Brachial Index (ABI) as an indicator. Result: The passive ROM intervention administered over three days resulted in improvements in ABI values, increased peripheral pulses, shortened capillary refill time (CRT), warm extremities, reduced muscle weakness, and decreased peripheral edema. Conclusion: Passive ROM exercises of the lower extremities combined with 30° leg elevation are effective nursing interventions for improving ABI values, peripheral pulses, capillary refill time (CRT), extremity warmth, muscle weakness, and peripheral edema in patients with CHF. Consistent application of passive ROM interventions to the lower extremities can support the rehabilitation process.
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