Chronic Renal Failure

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Chronic Renal Failure: Made Easy:

Jurmaida H. Pagayao , BSN, RN Chronic Renal Failure: Made Easy

Overview of CRF:

Overview of CRF

Definition :

Definition Inability of the kidneys to perform vital functions including excretion of: Toxins Electrolytes Fluids Hydrogen ions

Incidence :

Incidence Affects more than 2 out of a 1000 population in the US annually

Onset :

Onset Gradual Over many years

Etiology :

Etiology Diabetes – cause of CRF in 40% of all cases Hypertension – cause of CRF in 25% of all cases

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Other Causes: Trauma Autoimmune disorders Birth defects Drug overdose Genetic diseases

Clinical Findings:

Clinical Findings Edema throughout the body Shortness of breath Fatigue Flank pain Oliguria (progressing to anuria) Elevated BP Pale skin

Nursing focus:

Nursing focus

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Never take a BP or perform a venipuncture on an arm with a dialysis shunt Help minimize discomfort from fluid restrictions by offering: Ice chips Frozen lemon swabs Diversional activities Hard candies

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Fluids are typically restricted to an amount equal to the previous day’s urine output plus 500- 600mL Perform frequent turning and ROM exercises to minimize skin breakdown

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Provide routine skin care Uremia causes itching and dryness of skin Monitor: Blood urea nitrogen (BUN) and serum creatinine levels Monitor strict fluid intake and output

Patient teaching:

Patient teaching

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Provide patient with literature on CRF and/or dialysis Restrict sodium, water, potassium, phosphate, and protein intake as ordered

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Encourage compliance with secondary preventive measures Explain the actions, dosages, side effects, and adverse effects of meds

Thank You!:

Thank You!

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