Putri Bahriantari Dzakwan, . (2026) IMPLEMENTASI RESTRIKSI CAIRAN TERHADAP PASIEN GAGAL GINJAL KRONIS (GGK) DENGAN HIPERVOLEMIA DI RS DI JAKARTA. Tugas Akhir thesis, Universitas Pembangunan Nasional Veteran Jakarta.
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Abstract
Background: Fluid restriction is an important nursing intervention to manage fluid volume overload; however, global patient non-compliance remains at 30-60%, posing a risk of hypervolemia that can worsen cardiovascular function. One vulnerable group is patients with chronic kidney disease (CKD). The main challenge is persistent thirst, which can be managed through chewing gum, sipping ice, and mouth rinsing with plain water. Objective: To describe the implementation of nursing care, particularly fluid restriction, in a CKD patient with hypervolemia. Method: A descriptive case study using a single case study approach on Mrs. S over 3 days. Data were collected through interviews, observation, physical examination, and documentation. Interventions included hypervolemia management, oxygen therapy, hemodynamic monitoring, fluid restriction education, and thirst management evaluated using the Thirst Distress Scale (TDS) and fluid balance monitoring. Results: On initial assessment, the patient presented with dyspnea, grade 2 edema, oliguria, fluid balance of +269 ml/24 hours, and a TDS score of 13 (severe). Supporting examinations revealed anemia (Hb 9.5 g/dL), creatinine 3.67 mg/dL, respiratory alkalosis (pH 7.52; pCO₂ 31.5 mmHg), left pleural effusion, cardiomegaly, and EF 29%. Three nursing diagnoses were identified: impaired gas exchange, decreased cardiac output, and hypervolemia. After 3 days of nursing intervention, impaired gas exchange was resolved, indicated by RR 20x/min and SpO₂ 98%; decreased cardiac output was partially resolved, indicated by BP 126/90 mmHg; and hypervolemia was partially resolved, shown by increased diuresis to 0.51 ml/kgBW/hour, improved fluid balance to -416 ml/24 hours, and TDS score decreasing from 13 (severe) to 3 (mild) following fluid restriction implementation. Conclusion: Nursing care was able to resolve impaired gas exchange and partially resolve decreased cardiac output and hypervolemia. Implementation of fluid restriction combined with thirst control techniques contributed to improved fluid balance and reduced thirst distress in CKD patients with hypervolemia.
| Item Type: | Thesis (Tugas Akhir) |
|---|---|
| Additional Information: | [No. Panggil: 2310701045] [Pembimbing: Hesti Rahayu] [Penguji 1: Gamya Tri Utami] [Penguji 2: Sudiharto] |
| Uncontrolled Keywords: | Nursing Care, Chronic Kidney Disease (CKD), Hypervolemia, Fluid Restriction, Thirst Distress Scale. |
| Subjects: | L Education > L Education (General) R Medicine > RT Nursing |
| Divisions: | Fakultas Ilmu Kesehatan > Program Studi Keperawatan (DIII) |
| Depositing User: | PUTRI BAHRIANTARI DZAKWAN |
| Date Deposited: | 27 Aug 2026 04:23 |
| Last Modified: | 27 Aug 2026 04:23 |
| URI: | http://repository.upnvj.ac.id/id/eprint/53517 |
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