17 Chronic Renal Failure Nursing Care Plans

March 10, 2014

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:

Risk for Impaired Oral Mucous Membrane

Risk for Impaired Oral Mucous Membrane: Disruptions of the lips and soft tissues of the oral cavity

Risk factors may include

Lack of/or decreased salivation, fluid restrictions
Chemical irritation, conversion of urea in saliva to ammonia

Possibly evidenced by

Not applicable. Existence of signs and symptoms establishes an actual nursing diagnosis.

Desired Outcomes

Maintain integrity of mucous membranes.
Identify/initiate specific interventions to promote healthy oral mucosa.

Nursing Interventions	Rationale
Inspect oral cavity; note moistness, character of saliva, presence of inflammation, ulcerations, leukoplakia.	Provides opportunity for prompt intervention and prevention of infection.
Provide fluids throughout 24-hr period within prescribed limit.	Prevents excessive oral dryness from prolonged period without oral intake.
Offer frequent mouth care and rinse with 0.25% acetic acid solution; provide gum, hard candy, breath mints between meals.	Mucous membranes may become dry and cracked. Mouth care soothes, lubricates, and helps freshen mouth taste, which is often unpleasant because of uremia and restricted oral intake. Rinsing with acetic acid helps neutralize ammonia formed by conversion of urea.
Encourage good dental hygiene after meals and at bedtime. Recommend avoidance of dental floss.	Reduces bacterial growth and potential for infection. Dental floss may cut gums, potentiating bleeding.
Recommend patient stop smoking and avoid lemon or glycerine products or mouthwash containing alcohol.	These substances are irritating to the mucosa and have a drying effect, potentiating discomfort.
Provide artificial saliva as needed (Ora-Lube).	Prevents dryness, buffers acids, and promotes comfort.
Administer medications as indicated such as antihistamines: cyproheptadine (Periactin).	May be given for relief of itching.