Gagal ginjal kronik merupakan suatu penurunan fungsi ginjal yang cukup berat dan irreversible, umumnya tidak pulih, dimana tubuh tidak mampu memelihara metabolisme dan gagal memelihara keseimbangan cairan dan elektrolit yang menjadikan menurunya volume vaskuler dan gangguan reabsornsi. Berdasarkan hasil dari system review metaanalysis yang dilakukan didapatkan prevalensi di dunia gagal ginjal kronik sebesar 13,4% (Hill et al,2016). Dan di Indonesia menurut Riskesdas (2018) terdapat 0,38% penderita terdiagnosa Gagal ginjal kronik dan terjadi peningkatan dari tahun sebelumnya. Tujuan penulisan adalah melakukan proses keperawatan, membandingkan antar terori dan kasus, mengidentifikasi faktor pendukung dan penghaambat, melaksanakan pemecahan masalah. Penyusuna laporan tugas akhir ini penulis menggunakan studi kasus. Subjek penelitian adalah Tn. R dengan gagal ginjal kronik di Ruang Anggrek A RSUD Tarakan Provinsi Kalimantan Utara. Hasil yang didapatkan terdapat lima masalah keperawatan yang ditegakkan pada Tn. R, pola nafas tidak efektif, hipervolemi, resiko perfusi perifer tidak efektif,nyeri akut, intoleransi aktivitas, ansietas, dan defisit pengetahuan. Dari hasil analisis didapatkan kesenjagan antara teori dan kasus pada Tn.R yaitu dari pengkajian pada aktivitas, sirkulasi, eliminasi, makanan/cairan, nyeri/kenyamanan, intergritas ego, neurosensori, keamanan, pernapasan. Pada diagnosa dikasus yaitu defisit nutrisi,gangguan intergritas, gangguan pertukaran gas. Intervensi harus disesuaikan dengan kondisi dan sarana prasarana. Evaluasi hasil yang didapatkan dari lima diagnosa keperawatan dua yang tidak teratasi dan tiga yang teratasi.

Kata kunci: Gagal Ginjal Kronik, Asuhan Keperawatan

Chronic renal failure is a fairly severe and irreversible decrease in kidney function, generally not recovered, where the body is unable to maintain metabolism and fails to maintain fluid and electrolyte balance which leads to decreased vascular volume and impaired reabsorption. Based on the result of the metaanalysis system review, the prevalence in the world of chronic kidney failure was 13,% (Hill et al, 2016). And in Indonesia, according to Riskesdas (2018), 0.38% of sufferers were diagnose with chronic kidney failure and there was an increase form the previous year. The purpose of this case study was to find out the nursing process, compare between theories and cases, identify supporting and inhibiting factors, and find out problem solving. The research subject was Mr. R with chronic renal failure in Anggrek A Room, Tarakan regional general hospital, north Kalimantan province. The results showed that there were five nursing problems that were enforced on Mr. R, namely ineffective breathing pattern, hypervolemia, risk of ineffective peripheral perfusion, acute pain, activity intolerance, anxiety, and knowledge deficit. From the result of the analysis, it was found that there was a gab between theory and case in Mr. R, namely from the assessment of activity, circulation, elimination, food/fluids, pain/comfort, ego integrity, neurosensory, safety, and breathing. The diagnosis in the case included nutritional deficits, integrity disorders, and gas exchange disorders. Interventions had to be adjusted to condition and infrastructure. From evaluation of five nursing diagnosis, two were not resolved and three were resolved. Keywords: Chronic Renal Failure, Nursing Care