What is a priority nursing diagnosis for a client with acute kidney injury?
Here we will formulate sample Acute Renal Failure (ARF) nursing care plans based on a hypothetical case scenario. Show
It will include three acute renal failure nursing care plans with NANDA nursing diagnoses, nursing assessment, expected outcome, and nursing interventions with rationales. 20 NANDA nursing diagnosis for chronic kidney disease (CKD) Case ScenarioA 58-year-old male presents to the ED with complaints of nausea, fatigue, and shortness of breath. The patient has a past medical history of diabetes and hypertension. The patient says he hasn’t felt well for the last few days but he has been checking his blood sugar and blood pressure, which have both been normal. The patient also says he hasn’t been urinating very frequently. Thinking he was dehydrated, the patient tried to drink more water, but his urine output did not increase and he started to notice more swelling in his lower extremities. Upon assessment, the patient is oriented to person, place, and situation but is slightly disoriented regarding the time. His temperature is 37.3 ˚C, heart rate is 92 BPM, blood pressure is 132/84 mmHg, respirations are 34 breaths per minute, and oxygen saturation is 95% on room air. His lung sounds reveal scattered crackles. +3 pitting edema is noted in the patient’s lower extremities. The patient’s abdomen appears distended. A 12-lead EKG is performed, revealing normal sinus rhythm with frequent PVCs. His blood sugar is 121 mg/dL. His blood work reveals potassium of 6.2 mmol/L, sodium 133 mmol/L, BUN 103 mg/dL, and creatinine 3.7 mg/dL. His hemoglobin and hematocrit are slightly low, 8.5 and g/dL and 27% respectively. The urinalysis reveals a specific gravity of 1.010. A renal ultrasound is performed and no obstruction is seen. The patient is admitted to the hospital for Acute Renal Failure. #1 Acute Renal Failure (ARF) Nursing Care Plan – Risk for electrolyte imbalanceNursing AssessmentSubjective Data:
Objective Data:
Nursing DiagnosisRisk for electrolyte imbalance related to renal dysfunction as evidenced by decreased sodium and elevated potassium, BUN, and creatinine. Goal/Desired OutcomeShort-term goal: By the end of the shift the patient’s potassium will return to a normal level. Long-term goal: The patient will have adequate urine output with normal electrolyte laboratory levels. Acute Renal Failure (ARF) Nursing Interventions with Rationales – Risk for electrolyte imbalance
#2 Acute Renal Failure (ARF) Nursing Care Plan – Impaired urinary eliminationNursing AssessmentSubjective Data:
Objective Data:
Nursing DiagnosisImpaired urinary elimination related to oliguria secondary to acute kidney injury as evidenced by low specific gravity, +3 pitting edema, and elevated BUN and creatinine. Goal/Desired OutcomeShort-term goal: By the end of the shift the patient’s BUN and creatinine will remain stable or begin to decrease. Long-term goal: The patient will retain full kidney function, independent of dialysis. Acute Renal Failure (ARF) Nursing Interventions with Rationales – Impaired urinary elimination
#3 Acute Renal Failure (ARF) Nursing Care Plan – Excess fluid volumeNursing AssessmentSubjective Data:
Objective Data:
Nursing DiagnosisExcess fluid volume related to decreased urine output secondary to kidney injury as evidenced by +3 pitting edema and elevated BUN and creatinine. Goal/Desired OutcomeShort-term goal: By the end of the shift, the patient’s urine output will be at least 30 ml an hour. Long-term goal: The patient’s BUN and creatinine will return to normal levels, urine output will normalize, and no excess swelling or edema will be present. Acute Renal Failure (ARF) Nursing Interventions with Rationales – Excess fluid volume
20 NANDA nursing diagnosis for chronic kidney disease (CKD) ConclusionTo conclude, here we have formulated a scenario-based nursing care plan for Acute Renal Failure. Prioritized nursing diagnosis includes risk for electrolyte imbalance, impaired urinary elimination, and excess fluid volume. Additionally, this sampleARFnursing care plan comprises nursing assessment, NANDA nursing diagnosis, goal, and interventions with rationales. Recommended Readings & ReferencesAckley, B., Ladwig, G., Makic, M., Martinez-Kratz, M., & Zanotti, M. (2020). Nursing Diagnoses Handbook: An Evidence-based Guide to Planning Care (12th ed.). Elsevier. Comer, S. and Sagel, B. (1998). CRITICAL CARE NURSING CARE PLANS. Skidmore-Roth Publications. Herdman, T., Kamitsuru, S. & Lopes, C. (2021). NURSING DIAGNOSES: Definitions and Classifications 2021-2023 (12th ed.). Thieme. Swearingen, P. (2016). ALL-IN-ONE CARE PLANNING RESOURCE (4th ed.). Elsevier/Mosby. What is a nursing diagnosis for AKI?Nursing Diagnosis
Decreased or no urine output. Anxiety. Fluid retention. General malaise. Nausea.
What are some nursing interventions for acute kidney injury?Decreased Cardiac Output Interventions. Administer oxygen. High-flow oxygen or a ventilator may be necessary to increase oxygenation for cardiac function and tissue perfusion.. Encourage bed rest. ... . Monitor electrolytes. ... . Administer medications as indicated.. What's an appropriate nursing intervention for a patient with AKI?Nursing Interventions. Monitor fluid and electrolyte balance. ... . Reducing metabolic rate. ... . Promoting pulmonary function. ... . Preventing infection. ... . Providing skin care. ... . Provide safety measures.. What is the appropriate nursing responsibility for a patient diagnosed with acute renal failure?Nursing goal of treating patients with acute renal failure is to correct or eliminate any reversible causes of kidney failure. Provide support by taking accurate measurements of intake and output, including all body fluids, monitor vital signs and maintain proper electrolyte balance.
What is the priority nursing diagnosis with a patient diagnosed with end stage renal disease?Diagnosis. Based on the assessment data, the following nursing diagnoses for a patient with chronic renal failure were developed: Excess fluid volume related to decreased urine output, dietary excesses, and retention of sodium and water.
What are nursing interventions for kidney failure?Nursing Interventions:
Monitor ABG levels as necessary to evaluate acid-base balance. Weigh the patient to provide an index of fluid balance. Measure blood pressure at various times during the day with patients in supine, sitting, and standing positions. Adjust fluid intake to avoid volume overload and dehydration.
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