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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Acute Pain

Nursing Diagnosis

  • 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.

Assessment

Patient may manifest: 

  • Facial Grimaces
  • Guarding behaviors
  • Costovertebral pain/ Flank pain
  • Limited ROM
  • Body weakness
  • Facial Mask
  • Narrowed Focus
  • Sleep Disturbance
  • Diaphoresis
  • RR & BP changes

Diagnosis

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  • Acute Pain

Planning

  • Patient will demonstrate use of relaxation skills to relieve pain.
  • Patient will report relief/control of pain.
Nursing InterventionsRationale
Establish rapport.To get the cooperation of the patient and SO.
Monitor and record vital signs.To obtain baseline data.
Assess pt’s general conditionTo 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 painTo 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 vesselsObservation may/ may not be congruent with verbal reports indicating need for further evaluation.
Assess for referral pain as appropriateTo 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 reinforceTo 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
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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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