Common Sense on Acute Renal Failure

The course of Acute Renal Failure can be divided into three periods:
ⅠClinical manifestations of oliguria period:
High blood pressure, pulmonary edema, heart failure and cardiac arrest occur due to the retention of water and low sodium in the body, and hyperkalemia, which are caused by the obviously decreasing renal filtration rate.
ⅡClinical manifestations of polyuria period:
●At the beginning of polyuria period, the symptom will not be improved, however, even worse, and the patients will feel better when urea nitrogen and creatinine start to decrease.
●As a result of polyuria, the edema will disappear, and urea nitrogen and creatinine will gradually return to normal after one week. On the other hand, dehydration will happen, which is accompanied by low serum sodium and hyperkalemia following electrolyte excreted together with urine.
Ⅲ Clinical manifestations of recovery period:
This period will last for 6 months, during which the function of patient will become normal day by day. The abnormal condition of renal function indicates the permanent damage on kidney.
Nursing diagnosis
ⅠExcessive body fluid is related to the damaged renal filtration.
ⅡThe risk of infection is related to the limited intake of protein, dialysis and the declined immunity
ⅢPotential complications: high blood pressure, cardiac arrest, arrhythmia, pericarditis, etc.
Nursing care
ⅠObservation: Observe signs of life and record 24 h output and intake.
Ⅱ Strictly control the intake of fluid:
the intake of fluid= 500ml + the output of the day before
Ⅲ Diet nursing
1. The patients who can eat should be provided with light liquid or semifluid meal, and limited water, sodium salt, sylvite and protein.
2. The patients who cannot eat should be provided with high quality of protein by intravenous injection.