I.

Nursing Care Plans

A. Prioritization of Problems

a.1. List of Problems

1. ALTERED RENAL PERFUSION related to glomerular malfunction
2. FLUID VOLUME EXCESS related to glomerular filtration and sodium retention
3. IMBALANCED NUTRITION: LESS THAN BODY REQUIREMENTS
4. RISK FOR DECREASED CARDIAC OUTPUT
5. RISK FOR INFECTION

a.2. Basis for Prioritization

NURSING DIAGNOSES
1. ALTERED RENAL
PERFUSION related to
glomerular malfunction
JUSTIFICATION
Based on the Maslow’s Hierarchy of Needs, physiological
or biological needs should be prioritized first. Although the
other problems are also related to physiological and
biological needs, Altered renal perfusion is the most
priority. This is in connection to the kidneys that are
malfunctioned and hemodialysis is the only way to filter out
the blood and keeps the patient alive.

2. FLUID VOLUME EXCESS
related to glomerular filtration
and sodium retention
When following our ABC/ MAAUAR in nursing, Fluid
volume excess is the second priority next to Altered Renal
perfusion. This Fluid volume excess is considered in the
circulation; also, it is 2nd priority in the MAAUAR, the
impairment of the urinary elimination.

3. IMBALANCED NUTRITION: This will be considered the next priority after Fluid volume
LESS THAN BODY excess were addressed because correction of the nutrition
REQUIREMENTS can be delayed but fluid volume excess together with
sodium retention and hypertension can be fatal if not
intervene immediately. According to Maslow, Nutrition is
part of the physiologic needs that should be met to survive.
4. RISK FOR DECREASED This is identified as the fourth priority nursing diagnosis
CARDIAC OUTPUT because this only occurs if all the first three nursing
diagnosis are not properly managed.

5. RISK FOR INFECTION This is identified as the last priority nursing diagnosis
because this only occurs if interventions were not done
properly or if there were complication during the course of
treatment.