Nursing Care Plan for Acute Renal Failure

Acute Renal Failure Pathophysiology

Acute renal failure (ARF) is a sudden and rapid deterioration in renal function that occurs over a few hours to days. ARF is characterized by a sudden decrease in glomerular filtration rate (GFR) and the inability of the kidneys to filter waste products from the blood effectively. The accumulation of these waste products leads to the development of metabolic acidosis and electrolyte imbalances, which can result in life-threatening complications.

Causes of Acute Renal Failure

• Dehydration
• Hypotension
• Sepsis
• Nephrotoxic drugs
• Contrast media
• Obstructive uropathy

Symptoms of Acute Renal Failure

• Urine output
• Fluid overload
• Electrolyte imbalances
• Metabolic acidosis
• Nausea
• Vomiting
• Changes in level of consciousness (LOC)

Subjective Data (Client may report)

• Decreased urine output
• Nausea
• Vomiting
• Fatigue

Objective Data

• Elevated serum creatinine and blood urea nitrogen (BUN) levels
• Electrolyte imbalances (hyperkalemia, hyperphosphatemia, hypocalcemia)
• Metabolic acidosis
• Fluid overload

Acute Renal Failure Risk Factors 

• advanced age
• Diabetes
• Hypertension
• heart failure
• liver disease
• sepsis

ARF Nursing Assessment

The nursing assessment for ARF includes monitoring vital signs, urine output, fluid and electrolyte balance, mental status, and skin integrity. Cardiac Function

• Increased blood pressure and/or heart rate
• Fluid overload
• Hypovolemia

Respiratory Function

• Decreased oxygen saturation
• Abnormal lung sounds
• Respiratory distress

Neurologic Function

• Altered mental status and/or level of consciousness
• Confusion or agitation

Sensory Function

• Impaired vision and/or hearing

Acute Renal Failure Labs

• Serum creatinine and BUN levels
• Electrolyte levels (potassium, sodium, calcium, phosphorus)
• Arterial blood gases (ABGs)

ARF Nursing Interventions

• Maintain fluid and electrolyte balance.
• Administer medications to manage symptoms and underlying conditions.
• Monitor for signs of fluid overload and hypovolemia.
• Provide nutritional support.
• Prevent infection and sepsis.

Goals and Outcomes for Acute Renal Failure

• Maintain fluid and electrolyte balance.
• Manage symptoms and underlying conditions.
• Preventing complications.
• Promote the recovery of renal function.

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