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!