(^388) Medical-Surgical Nursing Demystified
NURSING INTERVENTIONS
- Monitor vital signs.
- Monitor intake and output.
- Assess for side effects of medication.
- Teach patient that phenazopyridine will cause orange-colored urine.
Renal Failure
WHAT WENT WRONG?
A decrease in renal function can occur in an acute (sudden) or a chronic (pro-
gressive) manner. Acute renal failure can be broken down into pre-renal, renal, and
post-renal. Prerenal causes result from diminished renal perfusion. Hypovolemia
due to blood or fluid losses, diuretic use, third-spacing of fluids, reduced renal
perfusion due to NSAID use or CHF can cause pre-renal failure. Renal failure in
acute care patients most commonly results from acute tubular necrosis. Drug-
related reactions, particularly to antibiotics, may cause an allergic interstitial
nephritis. Pylenonephritis or glomerulonephritis may also cause renal failure.
Post-renal failure is due to some type of urinary tract obstruction, bladder outlet
obstruction, stone, prostate hypertrophy, or compression of ureter due to abdom-
inal mass.
Chronic renal failure is an irreversible disease due to damaging effects on the
kidneys caused by diabetes mellitus, hypertension, glomerulonephritis, HIV infec-
tion, polycystic kidney disease, or ischemic nephropathy.PROGNOSIS
In acute renal failure, kidneys start working following intensive treatment and rec-
tifying the underlying condition that caused the problem. In chronic renal failure,
the patient can die as a result of complications of the disease.HALLMARK SIGNS AND SYMPTOMS
- Azotemia—elevated BUN and creatinine
- If hypovolemic (pre-renal), tachycardia, orthostatic hypotension, dry skin, and
mucous membranes
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