(7) Neurological: anxiety, personality changes, delusions, hallucinations,
(8) Metabolic: water retention, sodium retention, potassium retention, and
c. Chronic renal failure may be caused by:
Nephrotoxic agents (drugs/toxins).
d. Onset of symptoms begins with generalized weakness, lethargy, headache,
and mild GI complaints, such as anorexia, nausea, and vomiting. If not diagnosed and
treated, uremia will progress to a state of total body involvement. The patient will
become increasingly somnolent. An ammonia odor will be evident on the breath, and
respirations will become Kussmaul in character. "Uremic frost," a powdery substance
composed of uric acid salts, will appear on the skin. Muscle twitching is followed by
convulsions, coma, and death.
2-33. MEDICAL TREATMENT
The basis of care in managing a patient with chronic renal failure is to:
a. Assist the diseased kidneys to maintain homeostasis for as long as possible.
b. Prepare the patient for dialysis/transplant when conservative, symptomatic
treatment is no longer effective.
(1) When the patient can no longer manage a normal lifestyle with
conservative treatment, dialysis is indicated.
(2) When end-stage renal failure occurs and the patient is facing imminent
death, kidney transplant is indicated.
2-34. NURSING IMPLICATIONS
Nursing management of the patient with chronic renal failure includes the