RNSG 2432 Enhanced Concepts of Adult Health

Module 13: Nursing Care of the Individual Experiencing a Renal Disorder: Chronic Renal Failure/ESRD/Transplant


Module Objectives:

Utilizing critical thinking and the nursing process, the student will:

1. Compare and contrast risk factors associated with chronic renal failure.

2. Analyze the etiology and pathophysiology of chronic renal failure:

  • . Diffuse, bilateral disease of the kidneys with progressive destruction and scaring
  • . Specific etiologies
  • . Stages- decreased renal reserve; renal insufficiency; renal failure; end-stage renal disease (ESRD)

3. Analyze the signs and symptoms and complications of chronic renal failure:

  • . Cardiovascular
  • . Hematologic
  • . Immune system
  • . Gastrointestinal
  • . Neurologic
  • . Musculoskeletal
  • . Endocrine and Metabolic
  • . Dermatologic

4. Integrate the diagnostic tests with the etiology, pathophysiology, and signs and symptoms for the following disorders:

  • . Urinalysis/culture;
  • . Blood studies: BUN, creatinine, electrolytes, CBC
  • . Creatinine clearance
  • . Renal ultrasonography
  • . Kidney biopsy

5. Formulate relevant prioritized nursing diagnoses that address physical, psychosocial, and learning needs.

  • . Impaired tissue perfusion
  • . Imbalanced nutrition: less than body requirements
  • . Risk for infection
  • . Disturbed body image
  • . Other

6. Formulate client and family centered goals that assist toward health promotion, maintenance, and/or restoration.

7. Prioritize and evaluate nursing interventions related to:

  • . Drug therapy
    1) Diuretics
    2) Antihypertensives
    3) Medications to manage electrolyte imbalances: oral phosphorus binding agents; other
  • . Diet therapy
    1) fluid management
    2) Increase carbohydrates
    3) Restrictions:
    • dietary protein
    • water and sodium
    • potassium
    • phosphorus
  • . Surgical/Medical interventions
    1) Renal replacement therapies: dialysis (hemodialysis; peritoneal dialysis; kidney transplant
    • Types of dialysis, management, potential complication, comparison, methods to access

    2) Renal transplant, tissue matching, potential rejection, immunosuppressive drugs, patient teaching

8. Evaluate and revise goals and modify the nursing care plan specific to the individual experiencing chronic renal failure.

9. Integrate associated issues and trends into nursing practice.

  • . Legal
  • . Ethical considerations

Learning Activities:

Review module objectives.

Required: 

 

Interactive exercises:

Case study/critical thinking activities

  • Nursing care plan:"A Client with End Stage Renal Disease" LeMone p. 786-787
  • Nursing research: "Evidenced-Based Practice for the Client on Hemodialysis" Lemon p. 785
  • Nursing care:"Nursing Care of the Client Having a Kidney Transplant" LeMone p. 783
  • Case study: Charlie 4 Star. Analyze the pros and cons of a transplant! (opt)
  • View Bill Peckham's Self Dialysis (*most interesting!)
  • Peritoneal dialysis video (Locate-Dialysis at Home- right side screen; view and discuss only!)
Web sites (opt)

Chronic Renal Failure:

Transplant

 

Review module objectives and check for knowledge gaps.

Required: Complete module quizzes:

  • Blackboard quiz: Renal: CRF (ESRD & Transplant)