RESUME INTERNATIONAL NURSING SEMINAR 2024

"Resilience a Nursing Journey: Ethical Considerations and Best Practices"

Disusun Oleh :

Dian Septyana
P1337420122342

KELAS REGULER 3
PROGRAM STUDI DIII KEPERAWATAN SEMARANG KELAS KENDAL
JURUSAN KEPERAWATAN
POLTEKKES KEMENTERIAN KESEHATAN SEMARANG
TAHUN 2024/2025
1. Speaker 1 : Jefri Ardianto, M.App.Sc
The presentation titled "Strategies for Health Worker in the Face of
International and Global Health Developments" highlights the evolving role of
healthcare workers in an increasingly interconnected world. Global health, as outlined,
focuses on interdisciplinary and cross-sectoral issues that necessitate collaboration
between countries to improve global health status and achieve equity. Key factors
driving these changes include increased population mobility, globalization of trade,
global disease outbreaks, climate change, and disparities in health status across
countries. The presentation emphasizes that the growing movement of people and
goods across borders can amplify the spread of diseases and introduce new challenges
that need to be addressed both locally and globally. Global health challenges such as
shifting patterns of infectious diseases, food and water scarcity, and extreme weather
events have created complex health problems, requiring health systems to adapt and
mitigate the impacts of climate change. For healthcare workers, particularly nurses,
challenges include increased workloads, cultural and language differences, and stress
on mental and physical health. The need for resilience in nursing is underscored, but
the presentation warns against placing the burden of resilience solely on individuals.
Instead, institutions must ensure that systemic support is provided. Ethical
considerations such as fairness, autonomy, and institutional responsibility play key
roles in fostering resilience among healthcare workers. The presentation discusses the
World Health Organization's (WHO) strategy for international health, which focuses
on collaboration with member states to strengthen global health systems through
guideline development, capacity building, information sharing, and rapid response to
health crises such as pandemics.
2. Speaker 2 : Elisa, S.Kep..Ns.,M.Kep
Anatomy And Fisology Kidney During Pregnancy
Kidney Size and Blood Flow: The kidneys enlarge by up to 1-1.5 cm in length during
pregnancy, primarily due to increased blood flow and vascular changes. Renal blood
flow increases by 50-80%, peaking in the second trimester, to meet the greater demand
for filtration and waste removal from both the mother and fetus. Physiological Changes
Increased Glomerular Filtration Rate (GFR): One of the most significant changes is an
increase in the glomerular filtration rate (GFR) by 40- 50% during early pregnancy,
peaking in the second trimester. This enhances the kidney’s ability to filter out
metabolic waste from both the mother and the fetus. Increased GFR results in a mild
reduction in serum creatinine and blood urea nitrogen (BUN) levels. Lower-than-
normal levels of these markers are typical in pregnancy.
Increased Renal Plasma Flow: Renal plasma flow (RPF) increases by up to 75% during
pregnancy. This is primarily due to the vasodilation of the renal vasculature, promoted
by hormonal changes, including increased progesterone, estrogen, and relaxin. Fluid
and Electrolyte Balance: There is an increase in sodium and water retention due to the
actions of aldosterone, progesterone, and estrogen. This is essential to maintain the
expanded blood volume needed during pregnancy, which increases by approximately
40-50%. The retention of sodium and water also contributes to the development of
edema, which is common in pregnancy.
Proteinuria: A small increase in urinary protein excretion is normal, but excessive
protein in urine can be a sign of conditions like preeclampsia. Glucosuria: Due to the
increased GFR, the kidney’s ability to reabsorb glucose may become overwhelmed,
leading to glucosuria (glucose in the urine) without necessarily having high blood
glucose levels. Acid-Base Balance: Pregnancy is associated with a mild respiratory
alkalosis because of increased ventilation. To compensate, the kidneys excrete more
bicarbonate, keeping acid-base balance in check.

➢ Kidney Health During Pregnancy

1) Preconception Kidney Check
2) Monitor Blood Pressure
3) Manage Blood Sugar
4) Hydration Balance
5) Regular Kidney Function Tests
 6) Adequate Protein Intake
7) Control Salt Intake
8) Treat Infections Promptly
9) Manage Pre-existing Kidney Conditions
10) Avoid Smoking and Alcohol
11) Address anemia
12) Consider Safe Pregnancy Interventions
13) Monitor Electrolyte Balance Be Aware of Fluid Retention
14) Avoid Herbal Supplements

➢ Kidney Health During Ppostparti

1) Postpartum Kidney Function Check
2) Monitor Blood Pressure
3) Manage Fluid Retention
4) Adequate Hydration
5) Balanced
6) Dietary Management
7) Avoid Herbal Supplements
8) Regular Blood Sugar Monitoring, Follow Up on Gestational Diabetes
9) Healthy Weight Management
10) And others
The kidney recovery time postpartum typically resumes within 6-12 weeks postpartum,
as the body gradually returns to its pre-pregnancy state, factors such as pre-existing
health conditions or pregnancy complications can extend this recovery period.
3. Speaker 3 : Dr. Sri Endang Windiarti, Skep.Ns.M.Kes
a) Anxiety
Uneasy mental condition that an individual experiences Generalized anxiety
Anxiety, tension, and difficulty unwinding Personal Not invariably harmful
essential to survival.
➢ Moderate anxiety
People's perceptions become more limited, they only pay attention to the things
that directly affect them, and they are still able to take action under the guidance
of others.
➢ Severe anxiety
The range of perception becomes quite limited. Focus is solely on precise, tiny
details, and is unable to consider broader things. Everything is done to lessen
worry; yet, in order to focus on other things, a lot of guidance or commands are
required.
b) Panic
A person becomes uncontrollable, There is a lack of detail awareness, unable to
comply with commands, The amount of motor activity has increased. Reduced
capacity to relate to others distortions of perception and loss of reason, usually
accompanied by a disorganized personality.
c) Triger stressor
➢ Threats to physical integrity,
➢ Threats to physiological disability,
➢ Decreased ability to perform ADL,
➢ Threats to self-system,
➢ Threats that can endanger self-identity,
➢ Self- esteem and social functioning.
d) Nursing diagnosis
➢ Anxiety,
➢ Coping ineffectiveness,
➢ Fear,
➢ Risk of injury,
➢ Helplessness,
➢ Sleep pattern disturbances,
➢ Sensory perception disturbances
 e) Planing
Objectives:
Clients demonstrate adaptive coping with stress
Implementation:
Reduce anxiety levels.

4. Speaker 4 : Dr. Nina Indriyawati, MNS.

Patient education is an important element of CKD management, as it helps them
understand their condition and improves their ability to self-manage disease risks.
However, despite the importance of this education, many patients with CKD have a
limited understanding of their disease. This suggests an urgent need to improve the
quality of education provided to patients. Besides education, psychosocial adjustment
is also an important aspect. This involves how patients adjust to the demands of their
disease, emotionally, cognitively and socially. In the early stages of diagnosis, many
patients feel confused and anxious about making treatment-related decisions, mainly
due to feelings of distress and uncertainty about treatment options. In the end, many
accept dialysis as the only solution.
Active patient engagement in self-care is crucial, especially in modifying
behaviors, monitoring complications, and undergoing regular dialysis therapy. This
engagement can be facilitated by adequate physical, cognitive, and psychological
capacity, as well as good health literacy. However, there are several barriers to patient
education. These barriers include limited initial understanding of CKD, low health
literacy, lack of access to needed information, and patient readiness to learn. To
overcome these barriers, innovative educational approaches are needed, such as self-
management support, shared decision-making, and utilization of digital media.

5. Speaker 5: Asst. Prof. Dr. Nonglak Methakanjanasak

Acessability Equity and Advocacy for CKD patients
1) Evidence Based Practice related to CKD
2) Strengthen care system Nurse Case manager Multidisciplinary Team
3) National Policy related to Research and Network development
4) Strengthen community care system Enhance lifestyle modification competency
of Village Health Volunteers
 ACCESS EQUITY ADVOCATE PATIENTS WITH CKD
1) Evidence Based Practice
2) Multidisciplinary Expert team
3) Empowerment
4) Health Literacy, Self management
5) IT support, Telehealth, Infographic, Website
6) Competency, Strengthening, CM, HVV
Efforts to improve CKD management in Thailand include early intervention
through primary care (NCD clinics), secondary care (CKD clinics), and tertiary care
(specialist nephrologists). Strengthening the healthcare system involves using nurse
case managers, multidisciplinary teams, and promoting telehealth services for
continuous care and lifestyle modification support.
SUBJECTS with diabetes had about 2.7 (95% CI = 1.6-4.7) times higher
prevalence of CKD than non-diabetic subjects. Subjects with hypertension had a risk
of having CKD of about 2. (95% CI = 1.4-2.7) times higher than non-hypertensive
subjects. Subjects with a history of kidney stone had about 2.7 (95% CI = 1.8-4.1) times
higher risk of CKD relative to subjects who had never had a history of kidney stones.
Stages Of Chronic Kidney Disease: normal function, mod toga of tumenon, moderate
loss pf function, severe loss of function, kidney failure.

6. Speaker 6 : MARE ELIE

“HAN UNIVERSITY OF APPLIED SCIENCES"
those changes, HAN invests in lasting connections, educating students to
become versa- tile and reflective professionals, HAN is committed to intensifying and
strengthening working relationship with they communities: smart (international)
partnerships in which knowledge, re-search and practice are not separate, but instead
combined to form knowledge ecosystems. HAN also provides good education and
research so we can train the professionals of the future in close connection with regional
national and international partners. Those means that they will have
students and professionals who are reflective. Who know who they are and what they
are capable of. After 4 years of training, students will be professionals who can deal
with change and are aware of their place in the world. Students who are stimulated in
their personal and social devel-opment such as the 21st century skills. So that, they’re
able to use their professional practice to make a meaningful contribution to the social
issues arising now, and in the future. To make a difference on a personal, professional
and social level both locally and inter-nationally students need reflection skills, cultural
sensitive communication skills, investigate ability, and moral sensitivity.
Students are encouraged to become reflective practitioners who understand their
capabilities and roles in a changing world. The curriculum fosters personal and social
development, equipping students with essential skills such as reflection, culturally
sensitive communication, moral sensitivity, and research abilities. Additionally, a
minor in internationalization includes seven weeks of theoretical preparation covering
topics like tropical diseases, primary healthcare, ethical dilemmas abroad, international
mental health, and community health.