Acute-on-Chronic Kidney Disease (AoCKD) merupakan kondisi di mana terjadi perburukan fungsi ginjal secara akut pada pasien yang sebelumnya telah mengalami Chronic Kidney Disease (CKD). AoCKD memperparah gangguan keseimbangan tubuh, seperti ketidakseimbangan cairan, elektrolit, perfusi ginjal, hingga fungsi jantung, serta dapat meningkatkan risiko komplikasi serius jika tidak ditangani secara tepat. Laporan Tugas Akhir ini bertujuan untuk menggambarkan penerapan asuhan keperawatan pada dua pasien dengan AoCKD di ruang rawat inap Dahlia B RSUD dr. H. Jusuf SK Tarakan. Metode yang digunakan adalah studi kasus deskriptif dengan pendekatan proses keperawatan meliputi pengkajian, diagnosis keperawatan, intervensi, implementasi, dan evaluasi berdasarkan standar SDKI, SIKI, dan SLKI. Diagnosis keperawatan utama yang diangkat meliputi nyeri akut, risiko ketidakseimbangan cairan, hipervolemia, risiko perfusi renal tidak efektif, risiko penurunan curah jantung, gangguan mobilitas fisik, intoleransi aktivitas, gangguan pola tidur, risiko ketidakseimbangan elektrolit, serta risiko defisit nutrisi. Hasil studi kasus menunjukkan bahwa intervensi keperawatan yang terarah seperti pemantauan ketat tekanan darah, edukasi pembatasan cairan, pemberian terapi nutrisi, serta teknik relaksasi menunjukkan adanya penurunan gejala dan mencegah komplikasi lanjutan. Laporan ini menjelaskan pentingnya peran perawat dalam melakukan deteksi dini terhadap perubahan kondisi klinis serta pemberian intervensi keperawatan sesuai kebutuhan pasien AoCKD. Perawat diharapkan mampu menerapkan praktik berbasis teori untuk meningkatkan kualitas hidup pasien secara menyeluruh.

Kata Kunci: Asuhan Keperawatan, Chronic Kidney Disease, Acute-on-Chronic Kidney Disease

Acute-on-Chronic Kidney Disease (AoCKD) is a condition marked by acute deterioration in kidney function in patients with pre-existing Chronic Kidney Disease (CKD). AoCKD exacerbates bodily imbalances, such as fluid and electrolyte disturbances, impaired renal perfusion, and cardiac dysfunction, increasing the risk of severe complications if not managed appropriately. This final project report aims to describe the implementation of nursing care for two AoCKD patients in the Dahlia B inpatient ward at RSUD dr. H. Jusuf SK Tarakan. The study employed a descriptive case study using the nursing process approach, encompassing assessment, nursing diagnosis, intervention, implementation, and evaluation by SDKI, SIKI, and SLKI standards. The primary nursing diagnoses included acute pain, risk of fluid imbalance, hypervolemia, risk of ineffective renal perfusion, risk of decreased cardiac output, impaired physical mobility, activity intolerance, disturbed sleep pattern, risk of electrolyte imbalance, and risk of nutritional deficit. The case study results demonstrated that targeted nursing interventions such as strict blood pressure monitoring, fluid restriction education, nutritional therapy, and relaxation techniques led to symptom reduction and the prevention of further complications. This report underscores the critical role of nurses in the early detection of clinical changes and the delivery of tailored interventions for AoCKD patients. Nurses are expected to apply theory-based practices to enhance patients' overall quality of life. Keywords: Nursing Care, Chronic Kidney Disease, Acute-on-Chronic Kidney Disease