Chronic Kidney Disease IV: Nursing Management

Nursing management of chronic kidney disease begins by reviewing the patient’s history for conditions like diabetes, hypertension, or prolonged use of nephrotoxic drugs.

During the physical examination, the nurse checks for peripheral edema, and uremia symptoms, like fatigue and pruritus.

Cardiovascular assessment includes monitoring for jugular vein distension, lung crackles, and ECG changes indicating hyperkalemia, like peaked T waves and a widened QRS complex.

Based on these assessments, potential nursing diagnoses include:

Excess fluid volume related to impaired kidney function, as evidenced by peripheral edema and an increased weight.

Decreased Cardiac Output related to electrolyte imbalance as evidenced by peaked T waves and widened QRS complexes.

The primary goals are maintaining fluid and electrolyte balance, promoting cardiac stability, and preventing complications.

The nurse achieves these by monitoring fluid intake and output, educating on a low-sodium diet, reinforcing medication adherence, and assessing vital signs for cardiac changes.