* Acute renal failure involves sudden loss of renal function due to reduced renal blood flow or glomerular or tubular dysfunction. Real blood flow can be reduced by hypotension, hypovolemia or shock.
* Chronic renal failure involves progressive loss of neghron function which can be slowed but is eventually irreversible, resulting in end-stage renal disease .Causes of chronic renal failure are developmental, congenital, septic disorders, tubular disorders.
High risk for infection.
–Altered nutrition less than body requirements.
1-Monitor for signs of fluid overload:
*Increased blood pressure
*Neck vein distention
*Adventitious breath sounds (wheezes, crackles)
2) Weigh the pt daily or more often.
3) Maintain strict intake and output records.
4) Inform the pt about fluid management goals.
5) Distribute fluid intake daily evenly throughout the entire day and night.
6) Encourage pt to express feelings and frustrations; give positive feedback.
7) Consult with a dietitian regarding the fluid plan and overall diet.
8) Monitor for signs and symptoms of metabolic acidosis:
-rapid, shallow respirations
-nausea & vomiting
-low plasma bicarbonate
-Low PH of arterial blood<7.35
-behavior changes, drowsiness, lethargy
9) limit fat and protein intake
10) Assess or signs and symptoms of hypocalcemia, hypokalemia, alkalosis as acidosis is corrected.
11) Monitor for S\S of hypernatremia with fluid overload:
-Edema, wt gain
12) Monitor sodium restriction
13) Monitor for S\S of hyperkalemia.
I hope that this topic will be useful for nursing students.