JOURNAL SURYA
Journal Media Communication Knowledge Health Faculty of Health Sciences.
University of Muhammadiyah Lamongan Page link: http://jurnal.
Hyperglycemia Management Using Progressive Muscle Therapy in Diabetes Mellitus Patients: Case Study Natasya Widya Rahma1.
Evi Munika1.
Fitria Asmorosari1.
Azizatul Maghfiroh1.
Rizqi Indah Fitrianti1.
Zufar Efendi1.
Trijati Puspita Lestari2 .
Andhika Wahyu Firdaus3 Student of Nursing Program.
Faculty of Health Sciences.
Universitas Muhammadiyah Lamongan.
Lamongan.
East Java.
Indonesia Lecturer of Nursing Program.
Faculty of Health Sciences.
Universitas Muhammadiyah Lamongan.
Lamongan.
East Java.
Indonesia Nurse of Aisiyah Bojonegoro Hospital.
Bojonegoro.
East Java.
Indonesia
ARTICLE INFORMATION
ABSTRACT
Article Process Submission : July 5, 2024 Revision : November 29.
Accepted : December 06.
Introduction: Diabetes Mellitus is a condition when blood sugar levels are in the high category or commonly called hyperglycemia, high blood sugar levels can cause several problems that often arise and can cause several complications that occur.
The limited implementation of non-pharmacological progressive muscle relaxation therapy is the basis for the implementation of this The purpose of this study was to analyze the management Co-Author of hyperglycemia in patients with Diabetes Mellitus.
Trijati Puspita Lestari Method: Case study design method was used in the study with three trijati_puspita_lestari@umla.
id clients, namely patients with Diabetes Mellitus.
The action given to Lecturer of Nursing Program, overcome this with progressive muscle relaxation therapy given 3 Faculty of Health Sciences, times for 3 consecutive days t.
This study was conducted at Universitas Muhammadiyah Aisyiyah Hospital Bojonegoro in September 2023.
The analysis was Lamongan.
Lamongan.
East Java, carried out using the SMART method .
pecific, measurable.
Indonesia achievable, relevant and time-bound goal.
The FIKes UMLA Medical Surgical Nursing Care format was used in the data Cite this as:
collection process to action evaluation.
Rahma.
Munika.
Results: The results of the case study showed that on the first day of Asmorosari.
Maghfiroh.
, the assessment of the three patients, blood glucose was found to be Fitrianti.
Efendi.
, in the high category.
After 3 days, nursing problem of blood glucose Lestari.
, and Firdaus.
instability was resolved, blood glucose levels improved , drowsiness .
Hyperglycemia decreased sufficiently, dizziness decreased , fatigue/lethargy Management Using Progressive decreased sufficiently and complaints of hunger decreased .
Muscle Therapy in Diabetes Conclusion: Progressive Muscle Relaxation Therapy is effective in Mellitus Patients: Case Study.
lowering blood glucose levels.
This therapy can be combined with SURYA: J.
Media Komunikasi pharmacological therapy such as insulin and oral medications and Ilmu Kesehatan, 16 .
, 16.
, 93- other treatments needed by patients with diabetes mellitus so that it can help medical personnel in stabilizing blood sugar levels in https://doi.
org/10.
38040/js.
patients with diabetes mellitus.
Keywords: diabetes mellitus, hyperglycemia management, progressive muscle relaxation SURYA Vol.
No.
December 2024
INTRODUCTION
Diabetes Mellitus is a condition where blood sugar levels are in the high category or commonly called hyperglycemia, which is characterized by a chronic absolute insulin condition that can affect carbohydrate , protein and fat metabolism .
by an imbalance or lack of insulin or an imperfect cellular response to insulin characterized by irregular metabolism.
Diabetes mellitus is a fairly common problem in Indonesia caused by either heredity or lifestyle.
(Hamidah et al, 2.
Data from the International Diabetes Federation (IDF) states that there were around 463 million people aged 20-79 years in the world who suffered from diabetes in 2019 with a prevalence 3% of all residents of the same age.
The prevalence of diabetes is estimated to increase with increasing population age to 19.
9% or 111.
million people aged 65-79 years.
The number is estimated to continue to increase to reach 578 million in 2030 and 700 million in 2045.
The Southeast Asia region is ranked 3rd with a prevalence of 11.
3% (Ministry of Health, 2.
East Java Province is one of the provinces that ranks 6th with the highest prevalence of diabetes in Indonesia, where the number of diabetes mellitus sufferers in East Java Province in 2021 reached 929,535 cases (Ministry of Health, 2.
Blood glucose is blood sugar derived from carbohydrates absorbed by food and stored in the liver and skeletal muscles in the form of Glycogen is a substance that is beneficial to the body in the metabolism process.
In medical science, measuring blood glucose levels in the form of blood glucose is used to diagnose diabetes mellitus.
The process of increasing blood glucose levels in the body can be caused by several factors ranging from inappropriate diet therapy, diet, rarely doing physical activity, excess weight .
, noncompliance with treatment .
ral or injectio.
to psychological factors such as anxiety and stress.
In addition, genetic factors are also one of the factors that can trigger diabetes.
where someone who has a lineage of diabetes sufferers is more at risk of developing diabetes.
(Fitriyah.
One characteristic that is typical of this disease is high blood sugar levels when checked at a health service center or other.
According to Wowor et al.
In this case, high blood sugar levels in the body can certainly cause several complaints that occur such as: feeling tired quickly, feeling thirsty SURYA Vol.
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December 2024 often, urinating frequently in the middle of the night, easily hungry, often feeling hungry, drastic weight loss, and wounds that do not heal and dry.
(Simanjuntak et al, 2.
Management of high blood sugar levels can be Pharmacological blood sugar level management is in the form of insulin injections, and administration of drugs containing anti-diabetic substances.
(Saraswati et al, 2.
In addition, general treatment for people with diabetes mellitus is diet, exercise, or physical For exercise or physical exercise that is recommended for people with diabetes mellitus, it includes light exercise that can be done in bed for.
Patients in the hospital, this exercise does not require special preparation, just light movement on the bed for about 5 to 10 minutes, for example moving both hands, fingertips, feet and head.
(Risfa, 2.
In addition, gymnastics can be done, this gymnastics must be accompanied by abilities that must be adjusted to the ability of the condition of the comorbid disease, and can also be done with progressive muscle relaxation.
Progressive muscle relaxation techniques are relaxation therapies given to patients by combining deep breathing exercises and a series of contractions and relaxation of certain muscles with the aim of helping to lower blood sugar levels in patients with diabetes mellitus (Ilmi et al.
The purpose of this study was to analyze the implementation of hyperglycemia management using progressive muscle relaxation therapy to reduce blood sugar levels in patients with diabetes METHOD This study used case study experiment research with the aim of exploring nursing problems in clients with Diabetes mellitus.
The approach method used is the nursing care approach which includes five nursing processes, implementation and ending with the nursing evaluation process.
The research subjects in this case study used by the author were three clients suffering from Diabetes Mellitus in the Hospital who met the following criteria: .
Clients with Diabetes Mellitus.
Clients with complaints of random blood sugar levels above or equal to 200 mg/dl .
Composmentis awareness.
Willing to be study respondents and sign informed Exclusion criteria were patients who were taking hyperglycemic drugs and insulin This study was conducted at Aisyiyah Hospital.
Bojonegoro in September 2023, with a sample of 3 patients with diabetes mellitus.
The variables measured in this study were the patient's blood sugar levels before and after the intervention.
Data collection in this application was carried out by observing the implementation of progressive muscle relaxation and measuring blood sugar levels using a glucometer before and after progressive muscle relaxation.
Progressive muscle relaxation was carried out for 3 days with a frequency of 1 time a day, namely in the morning for 20 minutes, carried out by the researcher .
The application was carried out on 3 patients with diabetes mellitus at Aisiyah Hospital.
Bojonegoro.
The intervention used is progressive muscle relaxation therapy, which is an intervention given to patients by combining deep breathing exercises and a series of contractions and relaxation of certain muscles with the aim of helping to lower blood sugar levels in patients with diabetes mellitus (Permatasari et al.
The steps for performing progressive muscle relaxation therapy are .
Training the hand muscles.
The method is to clench both hands, tighten the biceps and forearms for 5-7 seconds.
Encourage the client to think about how it feels and fully tense the muscles then relax for 15-20 seconds, .
training the back of the hand muscles, by bending both arms back at the wrists so that the muscles in the back of the hands and forearms tense, fingers facing the ceiling.
training the biceps .
arge muscles at the top of the base of the ar.
, by clasping both hands into fists, then bringing both fists to the shoulders so that the biceps muscles will become tense.
training the shoulder muscles.
Lift both shoulders as high as possible as if touching both ears.
Focus on the top, and neck.
(Putriarini, 2.
Movements 5 and 6, relax the facial muscles .
uch as the forehead, eyes, jaw, and mout.
wrinkling the forehead and eyebrows until the muscles are felt and the skin is wrinkled.
Then SURYA Vol.
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December 2024 close your eyes tightly so that it can be felt around the eyes and the muscles that control eye .
Jaw muscles.
Closing the jaw, followed by biting the teeth so that there is tension around the jaw muscles.
muscles around the mouth.
The lips are pursed as hard as possible so that tension will be felt around the .
is intended to relax the front and back neck muscles.
The movement begins with the back of the neck muscles and then the front of the neck muscles, place the head so that it can rest.
Press the head on the surface of the chair cushion in such a way that you can feel the tension in the back of the neck and upper back (Putriarini.
Movement .
to train the front neck muscles.
The movement brings the head to the front, then bury the chin into the chest, so that you can feel the tension in the front neck area.
to train the back muscles.
Lift the body from the back of the chair, arch the back, puff out the chest, hold the tense condition for 10 seconds, then relax.
When relaxed, put the body back on the chair while letting the muscles become limp.
chest Take a deep breath to fill the lungs with as much air as possible then hold for a few moments, while feeling the tension in the chest down to the stomach, then release.
train the abdominal muscles.
By pulling the stomach in tightly, hold it until it becomes tight and hard for 10 seconds, then release freely.
Movements 14-15 train the leg muscles .
uch as the thighs and Straighten both soles of the feet so that the thigh muscles feel tense.
Continue by locking the knees in such a way that the tension moves to the calf muscles.
Hold the tense position for 10 seconds, then release.
(Putriarini, 2.
Data collection in this study used the medical surgical nursing care format of FIKES Muhammadiyah University of Lamongan.
The outcome and evaluation criteria were arranged based on the Indonesian Nursing Outcome Standards for blood glucose levels (L.
(SLKI, 2.
In compiling this study, it was analyzed using the SMART method .
pecific, measurable, achievable, rel evant and time-bound ( Doran , 2.
RESULTS Table 1Assessment of Type 2 Diabetes Mellitus Patients at Aisyiyah Hospital.
Bojonegoro Client Data Name Gender Age Address Religion Work Ethnic group Marital Status Symtomps within one Current Blood Sugar Level Efforts to overcome Past medical history Patient 1 Mrs.
Woman 43 years old Bubulan.
Bojonegoro
Islam
Housewife SENIOR HIGH
SCHOOL
Java Marry Unstable blood sugar, body feels weak and stomach pain extends to the back 301 mg/dl Patient 2 Mrs.
Woman 43 years old Lamongan Islam Farmer Java Marry Unstable blood sugar and right abdominal Patient 3 Mr.
Man
51 years old
Bojonegoro
Islam
Self-employed SENIOR HIGH
SCHOOL
Java Marry High blood sugar, pain in DM 200 mg/dl 291/dl Reduce sweet food There isn't any There isn't any There isn't any Diabetes mellitus Diabetes mellitus Table 2Nursing Diagnosis.
Outcomes and Interventions (SDKI.
SIKI.
SLKI) Nursing SLKI
SIKI
Instability of Objectives & Outcome Criteria Hyperglycemia Management blood glucose Blood Glucose Stability Observation levels (D.
Objective: After nursing actions are 1.
Identify carried out for 3x24 hours, it is hoped that blood glucose levels will improve.
Identify increased insulin requirements .
recurrent illnes.
Monitor blood glucose levels, if Monitor for signs and symptoms of .
polydipsia, polyphagia, weakness, malaise, blurred vision, headach.
Monitor fluid intake and output Monitor urine ketones, blood gas orthostatic blood pressure and pulse Therapeutic Provide oral fluid intake Consult a physician if signs and symptoms of hyperglycemia persist or Facilitate ambulation if orthostatic SURYA Vol.
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Education Recommend avoiding exercise when blood glucose levels are greater than 250 mg/dl.
Recommend self-monitoring of blood glucose levels Encourage adherence to diet and Teach the indications and importance of urine ketone testing, if appropriate.
Teach diabetes management with progressive muscle relaxation Collaboration Collaboration in administering insulin, if necessary Collaboration in administering IV fluids, if necessary Collaboration in administering potassium, if necessary Table 3.
Blood Glucose Stability in Patients Indicator Blood Glucose Levels Sleepy Dizzy Tired/lethargic Complaints of hunger
Description: Client 1
Client 2
Blood Glucose Stability Day 1
Day 2
Day 3
1 2 3 4 5 1 2 3 4 5 1 2 3 4
Client 3
DISCUSSION