Chronic Renal Failure Nursing Diagnosis: Impaired Urinary Elimination RT Glomerular Malfiltration Assessment Subjective: (none) Objective: Increase

e 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 Long Term: After 1-2 days of nursing interventions, the patient will participate in measures to correct/compensate for defects Interventions 1. Establish rapport. 2. Monitor and record vital signs. Rationale 1. To get the cooperation of the patient and SO. 2. To obtain baseline data. 3. Assess pts general condition 3. To know what problem and interventions should be prioritize. 4. To assess for contributing or causative factors. 5. Enhance commitments to promoting optimal outcomes. 6. To assess degree of interference. 7. To assess retention 8. To investigate extent of interference Evaluation Short Term: The patient shall have demonstrated participation in his/her recommended treatment program Long Term: The patient shall have demonstrated behavior/lifestyle changes to prevent complications

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

6. Determine clients pattern of elimination 7. Palpate bladder 8. Investigate pain, noting location

9. Determine clients usual daily fluid intake 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. 15. Emphasize importance of adhering to treatment regimen

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