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Learn about the nursing care management of patients with chronic renal failure in this nursing study guide. What is Chronic Renal Failure?When the patient has sustained enough kidney damage to require renal replacement therapy on a permanent basis, the patient has moved into the fifth or final stage of CKD, also referred to as chronic renal failure.
PathophysiologyThere are many diseases that cause chronic renal disease; each has its own pathophysiology. However, there are common mechanisms for disease progression.
Predisposing Factors
Precipitating Factors Schematic Diagram Here’s a schematic diagram or concept map for Chronic Kidney Disease:
Clinical ManifestationsBecause virtually every body system is affected in ESRD, patients exhibit a number of signs and symptoms.
ComplicationsPotential complications of chronic renal failure that concern the nurse and necessitate a collaborative approach to care include the following:
Assessment and Diagnostic FindingsLaboratory studies required to establish the diagnosis of CRF include:
Medical ManagementThe goal of management is to maintain kidney function and homeostasis for as long as possible.
Nursing ManagementThe patient with ESRD requires astute nursing care to avoid the complications of reduced renal function and the stresses and anxieties of dealing with a life-threatening illness. Nursing AssessmentAssessment of a patient with ESRD includes the following:
DiagnosisBased on the assessment data, the following nursing diagnoses for a patient with chronic renal failure were developed:
Planning & GoalsMain Article: 6 Chronic Renal Failure Nursing Care Plans The goals for a patient with chronic renal failure include:
Nursing Priorities
Nursing InterventionsNursing care is directed towards the following:
EvaluationA successful nursing care plan has achieved the following:
Discharge and Home Care GuidelinesThe nurse should promote home and self-care to increase the esteem of the patient.
Documentation GuidelinesThe documentation in a patient with chronic renal failure should focus on the following:
Practice Quiz: Chronic Renal FailureHere’s a 5-item practice quiz for this Chronic Renal Failure Study Guide. Please visit our nursing test bank for more NCLEX practice questions. 1. A major sensitive indicator of kidney disease is: A. BUN level. B. Creatinine clearance level. C. Serum potassium level. D. Uric acid level. 2. Significant nursing assessment data relevant to renal function should include information about: A. Any voiding disorders. B. The patient’s occupation. C. The presence of hypertension or diabetes. D. All of the above. 3. Decreased levels of erythropoietin, a substance normally secreted by the kidneys, leads to which serious complication of chronic renal failure? A. Anemia. B. Acidosis. C. Hyperkalemia. D. Pericarditis. 4. Dietary intervention for renal deterioration includes limiting the intake of: A. Fluid. B. Protein. C. Sodium and potassium. D. All of the above. 5. In chronic renal failure (end-stage renal disease), decreased glomerular filtration leads to: A. Increased pH. B. Decreased creatinine clearance. C. Increased BUN. D. All of the above. Answers and Rationale 1. Answer: B. Creatinine clearance level.
2. Answer: D. All of the above.
3. Answer: A. Anemia.
4. Answer: D. All of the above.
5. Answer: D. All of the above.
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