Nursing management of the patient with chronic renal failure includes the following:<\/p>\n
a. Gastrointestinal.<\/strong><\/p>\n (1) Symptomatic treatment for nausea, vomiting, and diarrhea.<\/p>\n (2) Encourage a nutritious, appetizing diet of the patient’s preferred foods to combat anorexia and improve nutritional status.<\/p>\n b. Hematological.<\/strong><\/p>\n (1) Administer vitamin and mineral supplements as ordered.<\/p>\n (2) Observe skin and mucous membranes for evidence of bleeding or bruising.<\/p>\n (3) Implement the use of soft bristle toothbrush and electric razor.<\/p>\n c. Integumentary.<\/strong><\/p>\n (1) Use mild cleansers to avoid further skin irritation.<\/p>\n (2) Apply soothing lotions (p.r.n.).<\/p>\n (3) Administer prescribed antipruritics to combat itching.<\/p>\n d. Cardiovascular.<\/strong><\/p>\n (1) Administer prescribed medications for control of hypertension, pulmonary edema, and congestive heart failure.<\/p>\n (2) Monitor vital signs.<\/p>\n (3) Observe for dependent edema.<\/p>\n (4) Auscultate lungs for the presence of fluid.<\/p>\n e. Metabolic.<\/strong><\/p>\n (1) Observe strict I & O.<\/p>\n (2) Monitor blood levels of electrolytes.<\/p>\n (3) Check weight daily and assess for fluid retention.<\/p>\n (4) Implement prescribed dietary modifications.<\/p>\n (a) Sodium restriction to decrease water retention.<\/p>\n (b) Limited protein to decrease protein metabolism (protein metabolism will result in more nitrogenous wastes that cannot be filtered by the kidneys).<\/p>\n (c) Any dietary protein allowed must be of high biological value to provide the essential amino acids.<\/p>\n (d) High carbohydrate diet to provide energy and decrease protein metabolism.<\/p>\n (e) Potassium restrictions to avoid hyperkalemia (cellular potassium is released during protein metabolism. Hyperkalemia, or potassium intoxication, can cause severe cardiac arrhythmia\u2019s).<\/p>\n f. Neurological.<\/strong><\/p>\n (1) Frequent assessment of level of consciousness.<\/p>\n (2) Observation for mental status changes.<\/p>\n (3) Encourage family to report noted personality changes.<\/p>\n (4) Administer prescribed medications to manage muscle spasms and convulsive seizures.<\/p>\n","protected":false},"excerpt":{"rendered":" Nursing management of the patient with chronic renal failure includes the following: a. Gastrointestinal. (1) Symptomatic treatment for nausea, vomiting, and diarrhea. (2) Encourage a nutritious, appetizing diet of the patient’s preferred foods to combat anorexia and improve nutritional status. b. Hematological. (1) Administer vitamin and mineral supplements as ordered. (2) Observe skin and mucous … Continue reading 2-34. NURSING IMPLICATIONS<\/span>