6 Acute Renal Failure Nursing Care Plans


Acute renal failure (ARF), also known as acute kidney failure or acute kidney injury, is the abrupt loss of kidney function. The glomerular filtration rate (GFR) falls over a period of hours to a few days and is accompanied by concomitant rise in serum creatinine and urea nitrogen. If left untreated, acute renal failure may complicate to chronic renal failure.

The annual incidence of acute renal failure is 100 cases for every million people in the United States. It is diagnosed in 1% of hospital admissions.

Nursing Care Plans

Nursing goal of treating patients with acute renal failure is to correct or eliminate any reversible causes of kidney failure. Provide support by taking accurate measurements of intake and output, including all body fluids, monitor vital signs and maintain proper electrolyte balance.

Here are six (6) nursing care plans (NCP) and nursing diagnosis for patients with acute renal failure: 

  1. Excess Fluid Volume
  2. Risk for Decreased Cardiac Output
  3. Risk for Imbalanced Nutrition: Less Than Body Requirements
  4. Risk for Infection
  5. Risk for Deficient Fluid Volume
  6. Deficient Knowledge
  7. Other Possible Nursing Care Plans

Deficient Knowledge

Nursing Diagnosis

May be related to

  • Lack of exposure/recall
  • Information misinterpretation
  • Unfamiliarity with information resources

Possibly evidenced by

  • Questions/request for information, statement of misconception
  • Inaccurate follow-through of instructions/development of preventable
  • Complications

Desired Outcomes

  • Verbalize understanding of condition/disease process, prognosis, and potential complications.
  • Identify relationship of signs/symptoms to the disease process and correlate symptoms with causative factors.
  • Verbalize understanding of therapeutic needs.
  • Initiate necessary lifestyle changes and participate in treatment regimen.
Nursing InterventionsRationale
Review disease process, prognosis, and precipitating factors if known.Provides knowledge base from which patient can make informed choices.
Explain level of renal function after acute episode is over.Patient may experience residual defects in kidney function, which may or may not be permanent.
Discuss renal dialysis or transplantation if these are likely options for the future.Although these options would have been previously presented by the physician, patient may now be at a point when options need to be considered and may desire additional input.
Review dietary plan and restrictions. Include fact sheet listing food restrictions.Adequate nutrition is necessary to promote tissue healing; adherence to restrictions may prevent complications.
Encourage patient to observe characteristics of urine and amount, frequency of output.Changes may reflect alterations in renal function and need for dialysis.
Establish regular schedule for weighing.Useful tool for monitoring fluid and dietary needs.
Provide emotional support to the patient and family.To reassure them of the all the procedures that patient may undergo.
Review fluid restriction. Remind patient to spread fluids over entire day and to include all fluids (ice) in daily fluid counts.Depending on the cause and stage of ARF, patient may need to either restrict or increase intake of fluids.
Discuss activity restriction and gradual resumption of desired activity. Encourage use of energy-saving, relaxation, and diversional techniques.Patient with severe ARF may need to restrict activity and/or may feel weak for an extended period during lengthy recovery phase, requiring measures to conserve energy and reduce boredom.
Discuss reality of continued presence of fatigue.Decreased metabolic energy production, presence of anemia, and states of discomfort commonly result in fatigue.
Determine ADLs and personal responsibilities. Identify available resources and support systems.Helps patient manage lifestyle changes and meet personal needs.
Recommend scheduling activities with adequate rest periods.Prevents excessive fatigue and conserves energy for healing, tissue regeneration.
Review use of medication. Encourage patient to discuss all medications and herbal supplements with physician.Medications that are concentrated in and/or excreted by the kidneys can cause toxic cumulative reactions and/or permanent damage to kidneys. Some supplements may interact with prescribed medications and may electrolytes.
Stress necessity of follow-up care, laboratory studies.Renal function may be slow to return following acute failure (up to 12 mo), and deficits may persist, requiring changes in therapy to avoid recurrence.
Identify symptoms requiring medical intervention: decreased urinary output, sudden weight gain, presence of edema, lethargy, bleeding, signs of infection, altered mentation.Prompt evaluation and intervention may prevent serious complications or progression to chronic renal failure.

Recommended Resources

Recommended nursing diagnosis and nursing care plan books and resources.

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See also

Other recommended site resources for this nursing care plan:

Other care plans and nursing diagnoses related to reproductive and urinary system disorders:

Matt Vera is a registered nurse with a bachelor of science in nursing since 2009 and is currently working as a full-time writer and editor for Nurseslabs. During his time as a student, he knows how frustrating it is to cram on difficult nursing topics. Finding help online is nearly impossible. His situation drove his passion for helping student nurses by creating content and lectures that are easy to digest. Knowing how valuable nurses are in delivering quality healthcare but limited in number, he wants to educate and inspire nursing students. As a nurse educator since 2010, his goal in Nurseslabs is to simplify the learning process, break down complicated topics, help motivate learners, and look for unique ways of assisting students in mastering core nursing concepts effectively.
  • hello.
    i am happy to get help from ur this page.i was assigned fr this acute renal failure toic.i have done my assignment by taking help this page.i am obliged.shabana hameed.RN,BSCN.

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