Nursing Care in Acute kidney Failure

Nursing Care in Acute kidney Failure

Acute kidney Failure, also known as Acute Renal Failure, refers to the immediate deterioration of basic renal function, which causes a sharp drop in glomerular filtration and an increase in nitrogen products in the blood. This condition is potentially reversible, however, if it is not handled properly and on time, it can lead the patient to Chronic Renal Insufficiency.

The etiology depends physiopathologically on its location, so three can be described:

  • Prerenal: It is due to the poor contribution of blood to the glomerular capillary, without affecting it structurally, so it can be said that with the appropriate treatment and care it is highly reversible.
  • Renal or intrarenal: This is caused by an injury of the kidney parenchyma, usually by toxic. It is also considered reversible and has four phases: 1) Start or exposure to the toxic; 2) Oliguric, lasting from eight to fourteen days, observing diuresis below 400 ml / day; 3) Polyuria, lasts about ten days, but the nitrogen bodies are still elevated in blood and 4) Recovery phase: It refers to the improvement of renal function, this phase can last up to six months, being its highest difficulty, the ability to concentrate urine.
  • Postrrenal or Obstructive: As its name says, it occurs due to obstruction of the urinary tract, which if properly corrected, will evolve favorably.


  • Vital signs according to medical indication (depend on the patient’s condition).
  • Strict water balance.
  • Monitor respiratory pattern.
  • Rest + 30 ° backrest.
  • Diet for a patient with kidney Insufficiency (in general it should be composed of 10 – 15% of proteins, 55 – 70% of carbohydrates and 20 – 30% of lipids).
  • Weight every day (if the patient’s condition allows it).
  • Trans-urethral tube care (if necessary).
  • Take and timely report of laboratory tests according to medical advice.
  • Dilute the indicated drugs to the limit of their solubility to reduce the supply of liquids.
  • Comply diuretics according to medical indication.
  • Changes in position (depends on the patient’s condition).
  • To guide the patient and family about the treatment and prevention of future events.

Nursing care in the IRA is aimed at recovering kidney function and minimizing the risk of recurrence, so it is very important education that we provide to both the patient and his family.

Nursing diagnoses (according to NANDA) applicable:

  • Risk of electrolyte imbalance (195).
  • Excess volume of liquids (26).
  • Nausea. (134)
  • Interruption of family processes (60).
  • Risk of deterioration of skin integrity (47).

Leave a Reply