Chronic renal failure can result from diabetes, hypertension, glomerulonephritis, or other causes leading to irreversible kidney damage and decreased glomerular filtration rate. Key nursing priorities include monitoring for excess fluid retention and electrolyte imbalances, ensuring adequate nutrition given potential nausea or appetite changes, and supporting patient mobility despite possible fatigue. Outcome goals are normal fluid balance, adequate nutritional intake without signs of malnutrition, and activity levels within the patient's capabilities.

1. CHRONIC RENAL FAILURE
ANALYSIS/
NURSING CARE PLAN/ EVALUATION/ OUTCOME
PATHOPHYSIOLOGY ASSESSMENT NURSING DIAGNOSIS
IMPLEMENTATION CRITERIA
(in priority)
Subjective Data: 1. Excess fluid volume r/t 1. Monitor vital signs. 1. Pt experiences normal fluid
DM, HPN, Glomerulonephritis, Polycystic decreased urine output balance as evidenced by stable
Kidney Disease, Obstrution, Infection, Confusion, weakness, 2. Weigh daily.
Toxic agents fatigue and Na&H2O retention weight, normal VS, balanced I
3. Monitor I & O. & O.
SOB, pleuritic pain 2. Imbalanced nutrition, less
4. Assess nutritional status. 2. Pt maintains adequate
Metallic taste, anorexia, than body requirements
Irreversible nephron loss r/t anorexia, nausea, 5. Assess contributing nutritional intake as evidenced
nausea, mouth
vomiting factors t activity by being free of signs of
ulceration, bleeding
intolerance. malnutrition.
Glomerular hyperfiltration
Amenorrhea, decreased 3. Activity intolerance r/t
libido fatigue, anemia, 6. Limit fluid intake to 3. Pt maintains activity level within
(compensatory mechanism) prescribed volume.
retention of waste capabilities as evidenced by
Muscle cramps, pain,
products 7. Assist in coping with normal HR, BP during activity
loss of tone,
discomforts resulting from and absence of SOB,
Decreased GFR decreased ROM
fluid restriction. weakness, fatigue.
8. Assess for understanding
Objective Data:
Uremia of dietary restriction.
Altered LOC, tremors,
seizures, asterixis, 9. Provide food preference
behavioral changes within dietary restrictions.
Fluid & Accumulation Regulatory
electrolyte of uremic function Gray-bronze skin color, 10. Encourage high-calorie,
abnormalities toxins disorders dry flaky skin, pruritus, low-protein, low-sodium,
(hperkalemia) (pericarditis, (HPN, purpura, thin brittle low-potassium snacks.
pericardial anemia, nails, coarse thinning 11. Promote intake of high
effusion, metastatic hair biologic volume protein
pericardial calcification, HPN, generalized edema. foods
tamponade) renal JVD 12. Assist in performing
osteodystrophy)
Crackles, tachypnea, activities if fatigued.
Kussmaul breathing 13. Encourage alternating
Uremic fetor, vomiting activity with rest.
Testicular atrophy