Chronic Renal Failure (CRF) is a progressive reduction of functioning renal tissue such that the remaining kidney mass can no longer maintain the body’s internal environment. CRF can develop insidiously over many years, or it may result from an episode of a cure renal failure from which the client has not recovered.
The nursing goal for client’s with CRF is to prevent further complications and supportive care. Client education is also critical as this is a chronic disease and thus requires long-term treatment.
Nursing Care Plans
Below contains five nursing care plans for patients with chronic renal failure.
Fluid Volume Excess
Renal disorder impairs glomerular filtration that resulted to fluid overload. With fluid volume excess, hydrostatic pressure is higher than the usual pushing excess fluids into the interstitial spaces. Since fluids are not reabsorbed at the venous end, fluid volume overloads the lymph system and stays in the interstitial spaces leading the patient to have edema, weight gain, pulmonary congestion and HPN at the same time due to decrease GFR, nephron hyperthrophized leading to decrease ability of the kidney to concentrate urine and impaired excretion of fluid thus leading to oliguria/anuria.
Pain is a discomfort that is caused by the stimulation of the nerve endings. Any trauma that the kidney experience (by any caused or factors) perceive by the body as a threat, the body releases cytokine and prostaglandin causing pain which is felt by the patient at his/her costovertebral area/flank.
Altered Renal Tissue Perfusion
For optimal cell functioning the kidney excrete potentially harmful nitrogenous product-Urea, Creatinine, Uric Acid but because of the loss of kidney excretory functions there is impaired excretion of nitrogenous waste product causing in increase in Laboratory result of BUN, Creatinine, Uric Acid Level.
Impaired Urinary Elimination
Renal Failure is a problem which results to loss of kidney functions and as GFR decrease, the kidney cannot excrete nitrogenous product and fluid causing impaired in Urinary elimination and together with prolonged use of medications such as NSAIDs this will lead to further kidney destruction which may thus decreasing the glomerular filtration and destroying of the remaining nephrons. This will result into inability of the kidney to concentrate urine which makes the patient to have a nursing diagnosis of impaired urinary elimination.
Altered Nutrition: Less than Body Requirements
Due restricted foods and prescribed dietary regimen, an individual experiencing renal problem cannot maintain ideal body weight and sufficient nutrition. At the same time patients may experience anemia due to decrease erythropoietic factor that cause decrease in production of RBC causing anemia and fatigue
Other Possible Nursing Care Plans
- Hyperthermia due to possible infection or activation of inflammatory process,
- Impaired skin integrity due to edema,
- and deficient knowledge.