17 Chronic Renal Failure Nursing Care Plans

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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:

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  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
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Risk for Injury

Nursing Diagnosis

  • Risk for Injury

May be related to

  • Renal failure

Possibly evidenced by

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  • [not applicable]

Desired Outcomes

  • Child will not experience injury as evidenced by BP remains, Hgb and Hct remain > (specify lower limit), Child denies bone pain or sensory loss.
Nursing InterventionsRationale
Assess blood pressure for alterations; administer antihypertensives ordered.Provides data regarding hypertension evident in advanced renal disease.
Assess for sensory loss, confusion neurologic and changes in consciousness.Reveals possible changes in neurologic status as kidney function deteriorates and uremic syndrome appears.
Assess I&O, electrolyte panel, and creatinine; administer diuretics as
ordered.
Provides an indication of renal function affecting output with water and electrolyte retention as the disease progresses and nephrons are destroyed.
Assess bone pain and deformities affecting ambulation and activities; administer supplemental vitamin D, calcium, and alkalizing agents, as ordered.Provides an indication of osteodystrophy  caused by a calcium-phosphorus  imbalance resulting in bone  demineralization and growth retardation; kidney disease results in the inability to synthesize vitamin D needed to absorb calcium; acidosis causes dissolution of
alkaline salts of bone, phosphate is
increased, and calcium decreased as
glomerular filtration is reduced.
Monitor RBC, Hct, Hgb and administer
iron and transfusion of packed red
blood cells, as ordered.
Indicates the presence of anemia caused by the depleted production of erythropoietin by the declining kidneys and inadequate iron intake in a restricted diet.
Assess the presence of acidosis by pH,
bicarbonate losses and administer
alkalizing agents.
Provides an indication of impending metabolic acidosis due to the failure of the kidneys to excrete metabolic acids that are byproducts of metabolism; the hydrogen ion is retained and bicarbonate is lost as the tubules are unable to reabsorb it.
Instruct parents and child in dietary
needs, to decrease sodium, potassium, phosphorous, calcium, iron in the diet, to limit protein and water intake as ordered and amounts allowed; provide a list of allowed foods and sample menus for planning.
Promotes compliance with dietary inclusions or restrictions depending on the degree of renal failure.
Educate parents on medication administration including actions, dosage, frequency, side effects to report.Guarantees compliance with correct medication administration; long-term medications are given for disease to avoid complications and uremic syndrome.
Educate parents and child about dialysis procedure and frequency if appropriate; include biologic, psychological and social effects.Supplies information if dialysis is required; usually based on creatinine level which indicated the ability of the kidneys to excrete waste materials and the degree of renal failure.
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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.
    Best,
    Sue

    • 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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