d. Check weight daily.
e. Observe for signs of impending renal failure.
Nausea and vomiting.
Oliguria or anuria.
f. Implement and enforce ordered fluid and diet modifications.
Protein restriction (for impaired renal function).
Sodium restriction (if edema is present).
Fluid restriction (if edema is present).
(4) Increased dietary carbohydrate (to provide energy and reduce the
metabolism of protein).
2-32. CHRONIC RENAL FAILURE
a. Chronic renal failure is a progressive deteriorization of renal function. Renal
insufficiency progresses to renal failure, ending in uremia and its complications. Uremia
is the accumulation, in the blood, of substances ordinarily filtered by the kidneys and
excreted in the urine.
b. As renal function declines, the kidneys become increasingly unable to remove
(filter) the body's metabolic wastes. The products of protein metabolism accumulate in
the blood and other body fluids, causing disruption and imbalances throughout the
body. Such alterations include:
Gastrointestinal: anorexia, nausea, vomiting, and diarrhea.
Hematological: anemia, bleeding tendencies.
Integumentary: skin discoloration, pruritis.
Skeletal: osteomalacia, uremic bone disease.
Sexual/reproductive: decreased libido, impotence, amenorrhea.
(6) Cardiovascular: HTN, pulmonary congestion, pulmonary edema, and
congestive heart failure.