Nursing Care Plan (NCP) for a Patient with Acute Renal Failure

Name: Patient B Date: March 15, 2021

Age/Sex: 82/M Time: 11:20 AM / Shift:
7-3
ASSESSMENT DIAGNOSIS PLANNING IMPLEMENTATION RATIONALE EVALUATION
Subjective: Impaired Short-Term Independent: Short-Term
(None) Urinary Goal:  Encouraged fluid intake up  To help maintain renal Goal:
Elimination to 1,500–2,000 mL/day function, prevent infection
After 8 hours of After 8 hours of
Objective: associated with (within cardiac tolerance), and formation of urinary
proper nursing proper nursing
 Urinary retention mechanical including cranberry juice stones, avoid encrustation
obstruction interventions, the around catheter, or flush interventions, the
 Hematuria patient will be urinary diversion appliance patient was able
[enlarged able to to demonstrate
 Digital rectal prostate] demonstrate techniques or
examination: Huge techniques or  To wash out bacteria or behaviors to
prostate gland (w/ behaviors to avoid infections and limit alleviate or
benign features)  Maintained consistent fluid stone formation
alleviate or prevent
prevent intake retention/urinary
 PSA level: 50 ng/mL
retention/urinary infection.
 Ultrasound: Prostatic infection.  To provide more effective
volume: 670 g control and prevent the
possibility of recurrent
 Elevated hemoglobin  Kept bladder deflated by use infections Long-Term
level: 9.5 g/dL Long-Term of an indwelling catheter Goal:
Goal: connected to closed drainage
 Elevated creatinine After 7 days of
 To reduce the risk of
level: 179 µmol/L After 7 days of proper nursing
infection and/or autonomic
proper nursing hyperreflexia interventions, the
interventions, the  Checked frequently for patient was able
patient will be bladder distention and to achieve normal
able to achieve observe for overflow elimination
normal  To decrease risk of skin pattern. as
elimination irritation or breakdown and evidenced by:
 Cleansed perineal area and development of ascending
pattern.
keep dry and emphasized the infection  Voiding freely
importance of keeping the
area clean and dry; Provided
catheter care as appropriate GOALS MET
 To facilitate drainage,
prevent reflux and
complications of infection
 Demonstrated proper
positioning of catheter
drainage tubing and bag  To maintain low bladder
pressures

 Recommended client void or

catheterize on frequent,  To stimulate bladder
timed schedule emptying
References:
Doanges, M. E., Moorhouse, M. F., & Murr, A. C. (2019). Nurse’s Pocket Guide: Diagnoses, Prioritized Interventions, and
Rationales. (15th ed.). F. A. Davis Company

RNspeak. (2018). Benign Prostatic Hyperplasia – BPH Nursing Care Plan. https://rnspeak.com/bph-nursing-care-plan/
Wayne, G. (2017). 6 Impaired Urinary Elimination Nursing Care Plan. https://nurseslabs.com/impaired-urinary-elimination/