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

Anticipatory Grieving

Nursing Diagnosis

May be related to

  • Perceived potential loss of the child by parents
  • Perceived potential loss of physiopsychosocial well-being by child

Possibly evidenced by

  • Expression of distress of possible loss, impending kidney failure, kidney dialysis, unanticipated death of the child

Desired Outcomes

  • Parents and child will identify positive coping mechanisms.
  • Parents and child will begin to work through the grief process.
Nursing InterventionsRationale
Assess stage of grieving process, difficulties encountered, sentiments concerning long-term illness and potential loss of the child.Provides knowledge about the stage of grieving as duration to work through the process differs with individuals; the longer the illness, the greater the parents and significant others will be able to progress towards acceptance.
Encourage parent and child to express feelings and concerns about the current situation.Allows for feedbacks essential to work through grieving.
Provide emotional and spiritual support in an accepting environment and refrain from
discussions that will provoke guilt or anger.
Provides for the emotional needs of parents and assists them to adjust with a sick child without adding stressors that are hard to resolve.
Assist to identify and use effective coping methods and to understand situations over which they have no control.Promotes the use of coping mechanisms over a lengthy period of time of physical and emotional stress on significant others which may be positive or negative.
Teach parents of stages of grieving and behaviors that are common in resolving grief.Promotes understanding of feelings and behaviors that are exhibited by grief.
Assist parents and child to develop
coping skills, problem-solving skills, and approaches that may be used.
Promotes coping ability over a prolonged period of illness and assists in the resolution of family stress.
Refer to a social worker and/or counseling as indicated.Offers information and support to parents and family in need of psychologic, economic assistance.
Refer to clergy, local support groups for kidney diseases.Provides support and assistance in adapting and accepting chronic illness and services and information for care.

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.
  • Thank you Matt :) This helped me understand how to do a care plan. I was asked to do one without them showing us a sample first so I was completely lost. Thank you!

  • Hi Matt,
    I’m an RN BSN WCC x 25 years. What you’re doing is great. Keep up the good work. Only suggestion is to broaden examples of applicable POC’s in the community. Community nursing is becoming highly skilled. Especially with Covid. In many cases of CKD, in the community, the CG becomes a huge part of the POC. Teach and Assess must be added to POC.
    Keep going! Its not enough for our nursing students to pass the boards. They need to understand critical thinking, and be creative/problem solve now more than ever.

    • Hi Sue,

      We’ll do our best to include your suggestion on our nursing care plans (which we are currently updating). And I agree: thinking critically is a must skill. Thank you so much for your kind words!

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