17 Chronic Renal Failure Nursing Care Plans


Chronic renal failure (CRF) or chronic kidney disease (CKD) is the end result of a gradual, progressive loss of kidney function. The loss of function may be so slow that you do not have symptoms until your kidneys have almost stopped working.

The final stage of chronic kidney disease is called end-stage renal disease (ESRD). At this stage, the kidneys are no longer able to remove enough wastes and excess fluids from the body. At this point, you would need dialysis or a kidney transplant.

Nursing Care Plans

The nursing care planning goal for with chronic renal failure 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.

Below are 17 nursing care plans (NCP) and nursing diagnosis for patients with chronic renal failure or chronic kidney disease:

  1. Risk for Decreased Cardiac Output
  2. Risk for Ineffective Protection
  3. Disturbed Thought Process
  4. Risk for Impaired Skin Integrity
  5. Risk for Impaired Oral Mucous Membrane
  6. Deficient Knowledge
  7. Excess Fluid Volume
  8. Acute Pain
  9. Impaired Renal Tissue Perfusion
  10. Impaired Urinary Elimination
  11. Imbalanced Nutrition: Less than Body Requirements
  12. NEW Activity Intolerance
  13. NEW Disturbed Body Image
  14. NEW Anticipatory Grieving
  15. NEW Risk for Infection
  16. NEW Risk for Injury
  17. Other Possible Nursing Care Plans

Imbalanced Nutrition: Less than Body Requirements

Imbalanced Nutrition: Less Than Body Requirements: Intake of nutrients insufficient to meet metabolic needs.

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


  • Anorexia
  • Anemia
  • Fatigue
  • Reported inadequate food intake less than recommended daily allowance


  • Altered Nutrition: Less than body Requirement R/T Catabolic state, Anorexia and Malnutrition 2O to Renal Failure


  • Patient will display normalization of laboratory values and be free of signs of malnutrition.
  • Patient will demonstrate behaviors, lifestyle change to regain and maintain an appropriate weight.
Nursing InterventionsRationale
Establish rapportTo gain patient’s trust.
Assess general appearance and monitor vital signs.To establish baseline data.
Identify patient at risk for malnutrition.To assess contributing factors.
Ascertain understanding of individual nutritional needs.To determine what information to provide the patient.
Assess weight, age, body build, strength, rest level.To provide comparative baseline.
Assist in developing individualized regimen.To control underlying factors.
Provide diet modification as indicated.To establish a nutritional plans.
Determine whether patient prefers more calories in a meal.To establish a nutritional plans.
Avoid high in sodium-rich food.To prevent further increase in sodium level.
Promote relaxing environment.To enhance intake.
Provide oral care.To prevent further spread of dental caries.
Provide safety.To prevent injury.
Maintain bed rest.To decrease metabolic demand.
Change position every 2 hours.To prevent ulcerations.
Position the bed into semi-fowler’s position.To enhance lung expansion.
Limit fluid intake as ordered.To prevent water retention.
Encourage to do Passive range of motion exercise.To have proper circulation of blood.
Encourage early ambulation.To prevent muscle atrophy.
Regulate Intravenous line as Ordered.To maintain hydration status.
Administer Medications as ordered.To prompt treatment.

See Also

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Genitourinary Care Plans

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