Professional Documents
Culture Documents
Nursing Care Plan For Patient With Renal Failure
Nursing Care Plan For Patient With Renal Failure
Nursing care
care plan
plan for
for
patient
patient with
with renal
renal failure
failure
Presented by :
1
Obstructive uropathy
• Is an interference with the flow of
urine at any site along the urinary
tract which cause urine
accumulation causing infection and
then renal failure
• Caused by stones ,tumors
pregnancy and prostatic hyperplasia
2
Renal failure
• Loss of renal function
• May be acute or chronic
• The acute renal failure is an abrupt
reduction in renal functions
associated with oligurea (less than
400/day),fatigue,anorexia,nausea
and vomiting
3
Causes of acute renal
failure
• The most common cause of acute
renal failure is impaired renal
blood flow
• Renal vasoconstriction and
vascular disease (hypertension)
• Urinary tract obstruction
4
Clinical manifestations
• Oligurea (less than 400ml/day)
• Anuria(less than 50/day)
• Fatigue
• Anorexia
• Nausea
• Vomiting
• Increase creatinine and urea level in serum
5
Patient profile
• 59y female ,married
• Date of admission : 21-3-2004
• With acute renal failure secondary to
obstructive uropathy
• Uncontrolled diabetes mellitus
• Hypertension
• No previous hospitalization
• R leg pain caused by edema ( grade 0-1)
6
Physical assessment
• Height : 152 cm – weight :64 kg
• with recent loss of weight due to diarrhea and
vomiting for about 4 months
• Patient diet : renal – diabetic diet
• Allergic to eggs
• Vital signs:
1. Tem: 36.9 (oral)
2. BP: 180/83 mmHg
3. Respiration: 18 /min – reg
4. P: 85/min
5. Peripheral pulses : present
7
Lab results
BUN H 13.2 2.1-7.1
Na 136 136-145
K 4.4 3.5-5.1
chloride H 109 98-107
Bicarbona L 21 23-29
te
Glucose H 7.4 3.9-5.8
(fasting
Creatinine H 205 53-97
Calcium L 1.92 2.10-2.55
Phosphoru 1.40 0.87-1.45
s 8
Pharmacological therapy
Drug Dose/ Reason Nursing Patient
name .freq conside respons
ration e
Norflox 4ooMG Antibiotic Don’t No signs
acin PO Q12 H to administe of
prevent r with infection
infection food
Amlodip MG PO 5 Antihyper Monitor PB within
ine QD tensive BP and normal
cardiac
rhythm
Insulin SQ Q6H To control Monitor Patient
regular blood serum glucose
sugar glucose level is
9
level freq controlle
Other therapies
• IV solutions:
½ normal saline 100ml/hr
Prescribed to prevent dehydration which
may caused by diarrhea and vomiting
• Catheter :
22 G inserted on 21-3 and last changed
was on 27-3
Done to prevent further accumulation of
urine which may lead to infection of UT
10
Collaborative problems
• Obstructive uropathy
• Acute renal failure
• Diabetes mellitus
• Hypertension
11
Nursing diagnoses
• fluid volume excess related to decrease urine
out put and retention of sodium and water
• Altered nutrition ,less than body requirements
related to anorexia nausea and vomiting
• Activity intolerance related to fatigue and
retention of waste products
• Knowledge deficit about diabetes self care and
control of disease process
12
Nursing care plan
supportive nursing assessment data :
17
18