Renal Failure: Chronic (CRF)
Definition: CRF is a gradual and progressive loss of ability of kidneys to excrete wastes, concentrate urine, and conserve electrolytes. In contrast, acute renal failure occurs suddenly.
Clinical Findings: Edema throughout the body, SOB, fatigue, flank pain, oliguria (progressing to anuria), elevated BP, and pale skin.
- Never measure BP or perform venipuncture on an arm with a dialysis shunt.
- Help minimize discomfort from frustrations with fluid restrictions by offering ice chips, frozen lemon swabs, diversional activities, and hard candies.
- Provide routine skin care; uremia causes itching and dryness of skin.
- Monitor BUN and serum creatinine levels.
- Monitor strict fluid intake and output; fluids are typically restricted to an amount equal to previous day's urine output plus 500-600 mL.
- Perform frequent turning and ROM exercises to minimize skin breakdown.
- Provide Pt and family with literature on CRF and/or dialysis.
- Restrict sodium, water, potassium, phosphate, and protein intake as ordered.
- Encourage compliance with secondary preventive measures.
- Explain actions, dosages, side effects, and adverse reactions of meds