Chronic Renal Failure

Nursing Diagnosis: Impaired Urinary Elimination RT Glomerular Malfiltration

Assessment
Subjective:
(none)
Objective:
Increase in
Lab results
(BUN,
Creatinine,
Uric Acid
Level)
Oliguria
Anuria
Hesitancy
Urinary
Retention
(Dont forget
which of the
following signs
and symptoms
above that the
patient
manifested and
may manifest)

Nursing Diagnosis
Impaired Urinary
Elimination R/T
glomerular
Malfiltration AEB
Impaired excretion of
nitrogenous products
2O Renal Failure

Scientific
Explanation
Renal Failure is a
problem which results
to loss of kidney
functions and as GFR
decrease, the kidney
cannot excrete
nitrogenous product
and fluid causing
impaired in Urinary
elimination and
together with
prolonged use of
medications such as
NSAIDs this will lead
to further kidney
destruction which
may thus decreasing
the glomerular
filtration and
destroying of the
remaining nephrons.
This will result into
inability of the kidney
to concentrate urine
which makes the
patient to have a
nursing diagnosis of
impaired urinary
elimination.

Planning
Short Term:
After 2-3 hours of
nursing interventions,
the patient will
verbalize
understanding of
condition

Interventions
1. Establish rapport.
2. Monitor and record
vital signs.

1. To get the
cooperation of
the patient and
SO.
2. To obtain
baseline data.

3. Assess pts
general condition
Long Term:
After 1-2 days of
nursing interventions,
the patient will
participate in
measures to
correct/compensate
for defects

Rationale

4. Review for
laboratory test for
changes in renal
function.
5. Establish realistic
activity goal with
client.

3. To know what
problem and
interventions
should be
prioritize.

Evaluation
Short Term:
The patient shall
have
demonstrated
participation in
his/her
recommended
treatment
program

Long Term:
The patient shall
4. To assess for
have
contributing or
causative factors. demonstrated
behavior/lifestyle
changes to
5. Enhance
prevent
commitments to
promoting optimal complications
outcomes.

6. Determine clients
pattern of
elimination

6. To assess degree
of interference.

7. Palpate bladder

7. To assess
retention

8. Investigate pain,
noting location

8. To investigate
extent of
interference

9. Determine clients
usual daily fluid
intake

9. To help determine
level of hydration.
10. To assess level of
hydration.

10. Note condition of

skin and mucous
membranes, color
of urine.
11. Observe for signs
of infection
12. Encourage to
verbalize
fear/concerns
13. Emphasize the
need to adhere
with prescribe diet
14. Emphasize
importance of
having good
hygiene.

11. To help in treating

urinary alterations
12. Open expression
allows client to
deal with feelings
and begin
problem solving.
13. To prevent
aggravation of
disease
condition.
14. To promote
wellness.
15. To promote
wellness

15. Emphasize
importance of
adhering to
treatment regimen

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