monitoring fluids is by taking the patient’s weight daily.
When weighing the patient, make sure thatvariables such as amount of clothing, time, and specific scale used are kept the same to ensure accuracy.
If a patient’s weight changes by one pound that is equivalent to 500mL of fluid.
Treatment for acute renal failure is aimed at preventing further damage to the kidneys, resolvingany causative factors, and to allow healing to take place. Supportive measures help to control symptomsand prevent additional complications. Supportive measures include fluid and diet adjustments,supplementation to restore electrolyte balance, and dialysis if needed. Conditions that warranthemodialysis include hyperkalemia, severe metabolic acidosis, pulmonary embolism, and rising BUN.The initial cause of the kidney damage is determined and treated. Various medications are used to treatindividual symptoms or complications. Some examples of this are diuretic agents are used to treatoliguria and IV hypertonic glucose and insulin, sodium bicarbonate, and calcium gluconate to treathyperkalemia. Determination of chan
ges to the patient’s diet is
made based on the individual patient’s
needs. Carbohydrate intake is usually increased to prevent the breakdown of fat and protein.The nurse caring for a patient with acute renal failure must monitor fluid balance, givemedications as ordered, monitor for adverse effects, and monitor cardiac and respiratory function. Fearand anxiety may occur so it is important to provide honest answers to any questions the patient mighthave. Any specific questions about their prognosis should be referred to the physician. Due to electrolyteimbalances and reduced mobility, complications may arise in other body systems. It is important that thenurse be aware of these potential complications and performs the appropriate interventions to preventthem. It is important that the patient understand the reason for the interventions to increase complianceand improve self-care when discharged. Patient teaching is aimed at providing basic information aboutthe disease and any diagnostic tests, procedures, or treatments. Provide patient teaching about diet,management of fluids, drug therapy, activity, and signs and symptoms that should be reported to thephysician such as dyspnea, edema, or fever.Chronic renal failure is a progressive, irreversible decline in renal function in which the kidneyscannot maintain fluid and electrolyte balance. The most common causes of chronic renal failure arediabetes mellitus, hypertension, and vascular disorders. Chronic kidney infections, obstruction of urine,polycystic kidney disease, and nephrotoxic agents can lead to chronic renal failure as well. Chronic renalfailure is divided into three stages; stage 1 also called reduced renal reserve, stage 2 or renal insufficiency,and stage 3 or end-stage renal disease. During the reduced renal reserve stage, nephron function loss isabout 40%-70%. Typically the patient does not present with symptoms because the remaining nephronsare able to compensate for the decline in function. During the renal insufficiency stage, only 10%-25% of nephrons are functioning. Serum creatinine and BUN are elevated, urine output is significantly increased