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
Altered Renal Tissue Perfusion
- Ineffective Tissue Perfusion: For optimal cell functioning the kidney excrete potentially harmful nitrogenous product-Urea, Creatinine, Uric Acid but because of the loss of kidney excretory functions there is impaired excretion of nitrogenous waste product causing in increase in Laboratory result of BUN, Creatinine, Uric Acid Level.
- Increase in Lab results (BUN, Creatinine, Uric Acid Level)
- Pulmonary Congestion
- Altered Renal Perfusion RT Glomerular Malfunction
- Patient will demonstrate participation in his/her recommended treatment program.
- Patient will demonstrate behavior/lifestyle changes to prevent complications
|Establish rapport||To get the cooperation of the patient and SO.|
|Monitor and record vital signs.||To obtain baseline data|
|Assess patient’s general condition.||To obtain baseline data.|
|Determine factors related to individual situation and note situation that can affect all body system.||To assess causative and contributing factors|
|Note characteristic of urine: measure urine specific gravity.||To assess for hematuria and proteinuria and renal impairment.|
|Ascertain usual voiding pattern||To compare with current situation.|
|Note presence, location intensity duration of pain.||May indicate pain on affected organ|
|Note mentation status and review lab result such as BUN and creatinine levels.||increase BUN and creatinine levels may alter mentation|
|Monitor BP, ascertain patient’s usual range.||GFR may increase rennin and raise BP.|
|Observe for dependent generalized edema.||To note degree of impairment of renal function.|
|Measure urine output on a regular schedule and weigh daily.||To assess renal perfusion and function.|
|Provide diet restriction as indicated, while providing adequate calories.||Calories to meet body’s need while restriction of protein helps limit BUN.|
|Encourage discussion of feelings regarding prognosis or long term effects of discussion.||To decrease anxiety about condition and correct his wrong ideas about condition.|
|Identify necessary changes in lifestyle and assist client to incorporate disease management to ADLs.||To promote wellness and prevent further progression of complication.|
|Assess patient emotional/psychological factors affecting the current situation.||Stress or depression may be increasing the effect of an illness or depression might be the result of being forced into inactivity.|
|Establish realistic activity goal with patient.||Enhance commitments to promoting optical outcomes.|
|Give information about positive signs of improvement such as improve vital signs/ circulation.||To provide encouragement.|
|Provide physiologic support. Maintain calm attitude but admit concerns if questioned by the client/SO.||Honestly can be reassuring when so much activity or worries are apparent to the client or SO.|
|Review expectations of the patient/SO.||To establish individual goals.|
|Give patient information that provides evidence of daily/weekly progress.||To sustain motivation.|
|Encourage patient to maintain positive attitude; suggest use of relaxation technique such as guided imagery as appropriate.||To enhance sense of well being.|
|Administer medication as ordered.||For faster recovery. It is used to treat the client’s disease condition.|
|Promote overall health measure.||To promote wellness.|
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