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
- Acute Pain: Pain is a discomfort that is caused by the stimulation of the nerve endings. Any trauma that the kidney experience (by any causes or factors) perceive by the body as a threat, the body releases cytokine and prostaglandin causing pain which is felt by the patient at his flank area.
Patient may manifest:
- Facial Grimaces
- Guarding behaviors
- Costovertebral pain/ Flank pain
- Limited ROM
- Body weakness
- Facial Mask
- Narrowed Focus
- Sleep Disturbance
- RR & BP changes
- Acute Pain
- Patient will demonstrate use of relaxation skills to relieve pain.
- Patient will report relief/control of pain.
|Establish rapport.||To get the cooperation of the patient and SO.|
|Monitor and record vital signs.||To obtain baseline data.|
|Assess pt’s general condition||To obtain baseline data|
|Accept patient’s description of pain.||Pain is a subjective experience and cannot be felt by other.|
|Perform a comprehensive assessment of pain (location, onset, characteristics, and frequency)||To be able to compare changes from previous reports to rule out worsening of underlying condition/developing complications|
|Determine possible pathophysiology and causes of pain||To know underlying condition that leads to pain and possible management that would not further aggravate pain.|
|Assess patient’s perception along with behavioral and physiological responses.||To know clients attitude towards pain and use of specific pain and medication.|
|Perform pain assessment each time pain occurs, note and investigate changes from previous report.||To rule out worsening of underlying condition / development of complication.|
|Assess patient’s description of pain.||To acknowledge the pain experience convey acceptance of client’s response to pain.|
|Observe nonverbal cues including how client walks, holds body, sits, facial expressions, cool fingertips/ toes, which can mean constricted vessels||Observation may/ may not be congruent with verbal reports indicating need for further evaluation.|
|Assess for referral pain as appropriate||To help determine possibility of underlying condition or organ dysfunction requiring treatment.|
|Review patient’s previous experiences with pain and methods found either helpful or unhelpful for pain control in the past.||To rule out worsening of pain due to methods used.|
|Explore method for alleviation/ control of pain.||Timely intervention is more likely to be successful in alleviating pain.|
|Encourage verbalization of feelings about the pain.||To allow out let for emotions and enhance coping mechanism.|
|Provide quite environment, calm activities and adequate rest reinforce||To prevent fatigue and lessen stimuli.|
|Provide comfort measures such as back rub, change position, use of heat/ cold.||To provide non-pharmacologic pain management.|
|Instruct/encourage use of relaxation exercise such as focused breathing.||This is a form of relaxation technique that helps decrease level of pain.|
|Encourage diversional activities such as TV and socialization with others.||Provides diversionary activities that help block the perception of pain by the brain.|
|Assist with self-care activities.||To able to perform ADL’s and maintain good hygiene.|
|Assist in treatment of underlying disease process causing pain.||Evaluate effectiveness of therapies.|
|Provide for individualized physical therapy/ exercise program that can be continued by the client discharge refer to physical therapist.||To continue therapeutic effect and wellness for the patient|
|Administer analgesics as ordered.||Pharmacologic mgmt for pain|
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