CHRONIC RENAL FAILURE

GASTROINTESTINAL

SYMPTOMS

ELEVATED UREA FLUID RETENTION IN SIDE EFFECT OF

METABOLIC ACIDOSIS HYPERKALEMIA
NITROGEN LEVEL LUNG MEDICATIONS

Accumulation of excessive urea As the number of When kidneys fail

nitrogen in the blood due to
decreased renal filtration ability
and urea enzymes decompose
into ammonia which stimulate
the Gastrointestinal mucosa
functioning nephrons Sample drugs are they can no longer
Fluid retention in the lung
declines in CKD, acid remove excess
become especially severe Calcium-based and
excretion by an increase potassium, so the
when patients lie on bed Phosphate binders
in the ammonium level builds up in the
excreted per nephron, body.
greatly reduced function

NAUSEA AND
VOMITING
 CHRONIC RENAL FAILURE
POOR DIGESTIVE SYTEM
Due to failure to function
and decline in GFR by the
kidneys, creatinine, toxins
and wastes builds up in the
blood which stimulate the
digestive system that can
alterate the appetite
regulation
GASTROINTESTINAL
SYMPTOMS
SIDE EFFECTS OF
BAD TASTES IN MOUTH
MEDICINES INTAKE
There can also be much
CKD patients may need to
urea nitrogen
take some medicines to
accumulated in blood,
help relieve their
which will cause bad taste
symptoms. But the
mouth or ammonia taste
medicine intake may cause
in mouth, and this will
some severe side effects
affect their appetite.
LOSS OF APPETITE
ANOREXIA Weight loss

LOW IMMUNITY
Infection by bacteria is a
common reason of diarrhea.
Kidney disease patients with
low immunity have higher
risk of being infected by
bacteria such as Salmonella
and Shigella and Clostridium
difficile
CHRONIC RENAL FAILURE
GASTROINTESTINAL
SYMPTOMS
TOO MUCH FLUID IN
COLONITIS HYPOADRENOCORTICISM
INTESTINES
It is one of the common causes of diarrhea in Kidney damage is followed by
Kidney patients have the
CKD. Involved kidneys are unable in expelling reducing function of adrenal
symptom of swelling,
toxins out of the blood, thus accumulation and cortex (hypoadrenocorticism).
when the symptoms occur
threaten the internal organs including the Hypoadrenocorticism causes
to large range of patients
colon. It will stimulate intestine to speed up to decrease of gastric acid and
excrete the toxins. Intestinal contents contact pepsinum, so the absorption body, especially in
the mucosa in such a short time that will function of small intestine intestine. This causes too
influence digestion and absorption. decline. much fluid in intestines
DIARRHEA
DEHYDRATION
 CHRONIC RENAL FAILURE
NURING DIAGNOSIS AND INTERVETIONS
Altered Nutrition: Less than body
Deficient Fluid Volume related to diarrhea
Requirement R/T Catabolic state, Anorexia
and Malnutrition secondary to Renal Failure
Ascertain understanding of individual
nutritional needs.
Assess weight, age, body build, strength.
Assist in developing individualized regimen.
Provide diet modification as indicated.
Determine whether patient prefers more
calories in a meal.
Avoid high in sodium-rich food.
Promote relaxing environment.
Provide oral care.
Provide safety.
Maintain bed rest.
Change position every 2 hours.
Position the bed into semi-fowlers position.
Limit fluid intake as ordered.
Encourage to do Passive range of motion
exercise.
Measure I&O accurately. Weigh
daily. Calculate insensible fluid
losses.
Provide allowed fluids throughout
24-hr period.
Monitor BP (noting postural
changes) and HR.
Note signs and symptoms of
dehydration: dry mucous
membranes, thirst, dulled
sensorium, peripheral
vasoconstriction.
Control environmental
temperature; limit bed linens as
indicated.
Monitor laboratory studies
Risk for infection related to depression in
immunologic defenses
Promote good hand washing by patient and
staff.
Avoid invasive procedures, instrumentation,
and manipulation of indwelling catheters
whenever possible.
Use aseptic technique when caring and
manipulating IV and invasive lines. Change site
dressings per protocol. Note edema, purulent
drainage.
Provide routine catheter care and promote
meticulous perineal care. Encourage deep
breathing, coughing, frequent position
changes.
Assess skin integrity.
Monitor vital signs.
Monitor laboratory studies: WBC count with
differential.
Obtain specimen(s) for culture and sensitivity
and administer antibiotics as indicated.