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:

Acute Pain

Acute Pain: Unpleasant sensory and emotional experience arising from actual or potential tissue damage or described in terms of such damage; sudden or slow onset of any intensity from mild to severe with anticipated or predictable end and a duration of <6 months.

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

Acute Pain

Planning

Patient will demonstrate use of relaxation skills to relieve pain.
Patient will report relief/control of pain.

Nursing Interventions	Rationale
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