17 Chronic Renal Failure Nursing Care Plans


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:

  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

Altered Renal Tissue Perfusion

Ineffective Tissue Perfusion: Decreased in the oxygen resulting in the failure to nourish the tissues at the capillary level.

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)
  • Oliguria
  • Anuria
  • Edema
  • Pulmonary Congestion
  • Hypertension
  • Hematuria


  • 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
Nursing InterventionsRationale
Establish rapportTo 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 patternTo 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.

See Also

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