3 Altered Renal Tissue Perfusion Chronic Renal Renal Failure Nursing Care Plans [PDF]

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Medical Diagnosis: Chronic Renal Failure Problem: Altered Renal Perfusion RT Glomerular Malfunction Assessment Subjective: (none) Objective:  Increase in Lab results (BUN, Creatinine, Uric Acid Level)  Oliguria  Anuria  Edema  Pulmonary Congestion  Hypertension  Hematuria (Don’t forget which of the following signs and symptoms above that the patient manifested and may manifest)



Nursing Diagnosis



Scientific Explanation Altered Renal For optimal cell Perfusion R/T functioning the Glomerular kidney excrete Malfunction AEB potentially harmful Increase in BUN, nitrogenous Creatinine and Uric product-Urea, O Acid Level 2 to renal Creatinine, Uric Acid Failure. 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



Planning Short Term: After 2-3 hours of NI, the patient will demonstrate participation in his/her recommended treatment program.



Long Term: After 2-3 days of NI, the patient will demonstrate behavior/lifestyle changes to prevent complications



Interventions



Rationale



1. Establish rapport



1. To get the cooperation of the patient and SO.



2. Monitor and record vital signs.



2. To obtain baseline data



3. Assess patient’s general condition.



3. To obtain baseline data.



4. Determine factors related to individual situation and note situation that can affect all body system.



4. To assess causative and contributing factors



5. Note characteristic of urine: measure urine specific gravity. 6. Ascertain usual voiding pattern



7. Note presence,



5. To assess for hematuria and proteinuria and renal impairment. 6. To compare with current situation.



7. may indicate



Evaluation Short Term: The patient shall have demonstrated participation in his/her recommended treatment program



Long Term: The patient shall have demonstrated behavior/lifestyle changes to prevent complications



location intensity duration of pain.



8. Note mentation status and review lab result such as BUN and creatinine levels. 9. Monitor BP, ascertain patient’s usual range. 10. Observe for dependent generalized edema. 11. Measure urine output on a regular schedule and weigh daily. 12. Provide diet restriction as indicated, while providing adequate calories. 13. Encourage discussion of feelings regarding prognosis or long term effects of discussion. 14. Identify necessary changes in lifestyle



pain on affected organ



8. increase BUN and creatinine levels may alter mentation



9. GFR may increase rennin and raise BP.



10. To note degree of impairment of renal function. 11. To assess renal perfusion and function. 12. Calories to meet body’s need while restriction of protein helps limit BUN. 13. To decrease anxiety about condition and correct his wrong ideas about condition. 14. To promote



and assist client to incorporate disease management to ADLs.



wellness and prevent further progression of complication.



15. Assess patient emotional/psycholo gical factors affecting the current situation.



15. Stress or depression may be increasing the effect of an illness or depression might be the result of being forced into inactivity.



16. Establish realistic activity goal with patient.



16. Enhance commitments to promoting optical outcomes.



17. Give information about positive signs of improvement such as improve vital signs/ circulation.



17. To provide encouragement.



18. Provide physiologic support. Maintain calm attitude but admit concerns if questioned by the client/SO.



18. Honestly can be reassuring when so much activity or worries are apparent to the client or SO.



19. Review expectations of the patient/SO.



19. To establish individual goals.



20. Give patient information that provides evidence of daily/weekly progress.



20. To sustain motivation.



21. Encourage patient to maintain positive attitude; suggest use of relaxation technique such as guided imagery as appropriate. 22. Administer medication as ordered.



23. Promote overall health measure.



21. To enhance sense of well being.



22. For faster recovery. It is used to treat the client’s disease condition. 23. To promote wellness.