Hypervolemia is a common nursing problem in patients with Chronic Kidney Disease (CKD) undergoing hemodialysis due to the kidneys' inability to excrete excess body fluid. This condition is characterized by edema, dyspnea, hypertension, weight gain, and ascites, which may worsen the patient's clinical condition. The purpose of this case study was to implement nursing care for a patient with Chronic Kidney Disease undergoing hemodialysis who experienced hypervolemia at Dr. Harjono Regional Hospital, Ponorogo.
This study employed a case study design using the nursing process approach, including assessment, nursing diagnosis, intervention, implementation, and evaluation. Nursing care was provided for three consecutive days to one patient with Chronic Kidney Disease undergoing hemodialysis who experienced hypervolemia.
The assessment on the first day revealed dyspnea, bilateral lower extremity edema, ascites, hypertension, and weight gain, leading to the nursing diagnosis of hypervolemia. On the second day, dyspnea decreased, blood pressure improved, and urine output increased; however, edema remained. On the third day, the patient's condition improved, as indicated by better fluid balance and increased urine output, although the edema had not completely resolved; therefore, the hypervolemia was considered partially resolved.
Nursing care through monitoring fluid status, intake and output balance, daily body weight, fluid restriction education, and collaboration in hemodialysis therapy contributed to improving the patient's condition. Continuous monitoring of fluid status and adherence to fluid restriction and the hemodialysis schedule are essential to prevent recurrent hypervolemia.