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.
- Risk for Decreased Cardiac Output
- Risk for Ineffective Protection
- Disturbed Thought Process
- Risk for Impaired Skin Integrity
- Risk for Impaired Oral Mucous Membrane
- Deficient Knowledge
- Excess Fluid Volume
- Acute Pain
- Impaired Renal Tissue Perfusion
- Impaired Urinary Elimination
- Imbalanced Nutrition: Less than Body Requirements
- NEW Activity Intolerance
- NEW Disturbed Body Image
- NEW Anticipatory Grieving
- NEW Risk for Infection
- NEW Risk for Injury
- Other Possible Nursing Care Plans
Risk for Injury
- Risk for Injury
May be related to
- Renal failure
Possibly evidenced by
- [not applicable]
- Child will not experience injury as evidenced by BP remains, Hgb and Hct remain > (specify lower limit), Child denies bone pain or sensory loss.
|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|
|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
|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.|
Recommended nursing diagnosis and nursing care plan books and resources.
- Nursing Care Plans: Nursing Diagnosis and Intervention (10th Edition)
An awesome book to help you create and customize effective nursing care plans. We highly recommend this book for its completeness and ease of use.
- Nurse’s Pocket Guide: Diagnoses, Prioritized Interventions and Rationales
A quick-reference tool to easily select the appropriate nursing diagnosis to plan your patient’s care effectively.
- NANDA International Nursing Diagnoses: Definitions & Classification, 2021-2023 (12th Edition)
The official and definitive guide to nursing diagnoses as reviewed and approved by the NANDA-I. This book focuses on the nursing diagnostic labels, their defining characteristics, and risk factors – this does not include nursing interventions and rationales.
- Nursing Diagnosis Handbook, 12th Edition Revised Reprint with 2021-2023 NANDA-I® Updates
Another great nursing care plan resource that is updated to include the recent NANDA-I updates.
- Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5(TM))
Useful for creating nursing care plans related to mental health and psychiatric nursing.
- Ulrich & Canale’s Nursing Care Planning Guides, 8th Edition
Claims to have the most in-depth care plans of any nursing care planning book. Includes 31 detailed nursing diagnosis care plans and 63 disease/disorder care plans.
- Maternal Newborn Nursing Care Plans (3rd Edition)
If you’re looking for specific care plans related to maternal and newborn nursing care, this book is for you.
- Nursing Diagnosis Manual: Planning, Individualizing, and Documenting Client Care (7th Edition)
An easy-to-use nursing care plan book that is updated with the latest diagnosis from NANDA-I 2021-2023.
- All-in-One Nursing Care Planning Resource: Medical-Surgical, Pediatric, Maternity, and Psychiatric-Mental Health (5th Edition)
Definitely an all-in-one resources for nursing care planning. It has over 100 care plans for different nursing topics.
Other recommended site resources for this nursing care plan:
- Nursing Care Plans (NCP): Ultimate Guide and Database
Over 150+ nursing care plans for different diseases and conditions. Includes our easy-to-follow guide on how to create nursing care plans from scratch.
- Nursing Diagnosis Guide and List: All You Need to Know to Master Diagnosing
Our comprehensive guide on how to create and write diagnostic labels. Includes detailed nursing care plan guides for common nursing diagnostic labels.
Other care plans and nursing diagnoses related to reproductive and urinary system disorders:
- Acute Glomerulonephritis | 4 Care Plans
- Acute Renal Failure | 6 Care Plans
- Benign Prostatic Hyperplasia (BPH) | 5 Care Plans
- Chronic Renal Failure | 11 Care Plans
- Hemodialysis | 3 Care Plans
- Hysterectomy (TAHBSO) | 6 Care Plans
- Mastectomy | 14+ Care Plans
- Menopause | 6 Care Plans
- Nephrotic Syndrome | 5 Care Plans
- Peritoneal Dialysis | 6 Care Plans
- Prostatectomy | 6 Care Plans
- Urolithiasis (Renal Calculi) | 4 Care Plans
- Urinary Tract Infection | 4 Care Plans
- Vesicoureteral Reflux (VUR) | 5 Care Plans