Nursing care plan for acute kidney failure

Introduction

Acute kidney failure is a serious medical condition wherein the kidneys suddenly cease to function properly and result in the accumulation of waste products in the body. It is a dangerous condition that can be fatal if not treated properly. A nursing care plan for acute kidney failure is essential in providing the right care and treatment to those affected.

Assessment

Nurses involved in caring for patients with acute kidney failure must assess the patient’s condition and be informed about the clinical signs and symptoms as well as laboratory findings that may help in making a correct diagnosis. The assessment should include:

• History – This involves an understanding of the medical history of the patient and past treatments, if any.
• Physical signs – Are there any signs of fluid overload or fluid deprivation, peripheral edema or hypotension, or electrolyte disturbances including hyperkalemia or hyponatremia?
• Lab Reports – Nurses should be looking out for creatinine levels, BUN, urine output, and other laboratory tests that could aid in determining the severity of the kidney failure.

Nursing Diagnosis

Once the nurse has gathered enough information, they can arrive at a nursing diagnosis. This diagnosis helps in providing an accurate assessment that enables the nurse to plan, provide and evaluate the care provided. A few common nursing diagnoses for acute kidney failure are:

• Fluid volume excess (FVE) – This occurs due to the body’s inability to eliminate built up waste products.
• Electrolyte imbalance – The conditions that occur with acute kidney failure can lead to an imbalance in electrolytes such as potassium, calcium, magnesium, phosphorus, and sodium.

Outcomes

The nurse can then identify goals they would like to achieve through their care plan. For acute kidney failure, the following outcomes may be considered:

• Restore fluid balance – The patient should maintain euvolemic state, which can be monitored via daily weights, intake and output ratios, and serum electrolytes.
• Prevent further complications – This includes preventing or controlling the development of infection, sepsis, metabolic acidosis, hyperkalemia, or hypotension.
• Improve renal function – This requires optimizing nutrition, hydration status, medications, positioning, and other interventions.

Interventions

Nursing interventions for acute kidney failure should be tailored to the patient’s needs. These may include:

• Monitoring vital signs and laboratory values – This includes keeping track of blood pressure, heart rate, oxygen saturation, temperature, and electrolyte levels.
• Maintaining fluid balance – This includes monitoring fluid intake, output, and daily weights.
• Providing nutritional support – The nurse may provide nutrition support through oral diet or enteral nutrition, based on the patient’s needs.
• Medication therapy – The nurse should be able to provide appropriate medications to help manage the patient’s condition.
• Education – The nurse should actively educate the patient and family about the condition, so that they may understand the disease process better and make informed decisions.

Rationales

Every decision related to the nursing care plan should be based on evidence-based practice and rationales. Rationales provide the foundation upon which nurses can justify their decisions. For instance, administering electrolytes to a patient with acute kidney failure can prevent further organ damage and improve renal function.

Evaluation

Nursing interventions and care plans should be regularly evaluated to ensure that the patient is receiving appropriate care and making progress towards their goals. The evaluation should consider patient responses such as vital signs, lab reports, medications response, improvement in symptoms, and patient satisfaction.

Conclusion

Acute kidney failure is a medical emergency that requires careful and prompt management. A properly designed nursing care plan for this condition is therefore important for providing effective care and improving patient outcomes. Timely assessment, diagnosis, intervention, and evaluation are necessary to ensure that the patient receives the best possible care.

FAQs

1. What is acute kidney failure? - Acute kidney failure is a sudden decline in renal function that leads to an increase in waste products in the body, and if left untreated, can be fatal.
2. What is a nursing care plan? - A nursing care plan is a document created by nurses to help direct care and treatment, as well as ensure that all nursing goals are met.
3. What are some nursing interventions for acute kidney failure? - Monitoring vital signs and laboratory values, maintaining fluid balance, providing nutritional support, medication therapy, and education are all commonly used nursing interventions for acute kidney failure.
4. What is the difference between nursing interventions and rationales? - Nursing interventions are the steps taken to care for a patient, while rationales are the evidence-based justifications for why these interventions are chosen.
5. How is the effectiveness of a nursing care plan evaluated? - The effectiveness of a nursing care plan is evaluated by considering patient responses such as vital signs, lab reports, medications response, improvement in symptoms, and patient satisfaction.