This document provides an overview of chronic renal failure (CRF), including its definition as the inability of the kidneys to perform vital functions like toxin and fluid excretion, an incidence rate of over 2 per 1000 people in the US annually, and common causes like diabetes and hypertension. Clinical findings of CRF include edema, shortness of breath, fatigue, and restricted urine output. Nursing focuses for patients with CRF include avoiding blood pressure checks or venipuncture near dialysis shunts, helping with fluid restrictions, providing skin care to prevent itching and breakdown, and closely monitoring intake, output, and medication compliance.

1. Chronic Renal Failure: Made Easy
Jurmaida H. Pagayao, BSN, RN

2. OVERVIEW OF CRF

3. Definition
• Inability of the kidneys to perform
vital functions including excretion
of:
– Toxins
– Electrolytes
– Fluids
– Hydrogen ions

4. Incidence
• Affects more
than 2 out of a
1000 population
in the US
annually

5. Onset
• Gradual
• Over many years

6. Etiology
• Diabetes – cause of CRF in 40% of
all cases
• Hypertension – cause of CRF in
25% of all cases

7. • Other Causes:
– Trauma
– Autoimmune disorders
– Birth defects
– Drug overdose
– Genetic diseases

8. Clinical Findings
• Edema throughout the body
• Shortness of breath
• Fatigue
• Flank pain
• Oliguria (progressing to anuria)
• Elevated BP
• Pale skin

9. NURSING FOCUS

10. • Never take a BP or perform a
venipuncture on an arm with a
dialysis shunt
• Help minimize discomfort from
fluid restrictions by offering:
– Ice chips
– Frozen lemon swabs
– Diversional activities
– Hard candies

11. – Fluids are typically restricted to an
amount equal to the previous day’s
urine output plus 500-600mL
• Perform frequent turning and
ROM exercises to minimize skin
breakdown

12. • Provide routine skin care
– Uremia causes itching and dryness
of skin
• Monitor:
– Blood urea nitrogen (BUN) and
serum creatinine levels
• Monitor strict fluid intake and
output

13. PATIENT TEACHING

14. • Provide patient with literature on
CRF and/or dialysis
• Restrict sodium, water, potassium,
phosphate, and protein intake as
ordered

15. • Encourage compliance with
secondary preventive measures
• Explain the actions, dosages, side
effects, and adverse effects of
meds

16. Thank You!