NCLEX RN Practice Question 444

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Nclex Practice Questions:

CHRONIC RENAL FAILURE

Description

  • CRF is a slow, progressive, irreversible loss in kidney function, with a GFR less than or equal to 60 mL/min for 3 months or longer.
  • It occurs in stages and results in uremia or endstage renal disease (Table 62-1).
  • Hypervolemia can occur because of the kidneys’ inability to excrete sodium and water; hypovolemia can occur because of the kidneys’ inability to conserve sodium and water. Chronic renal failure affects all major body systems and requires dialysis or kidney transplantation to maintain life.

Primary causes

  • May follow ARF
  • Diabetes mellitus and other metabolic disorders
  • Hypertension
  • Chronic urinary obstruction
  • Recurrent infections
  • Renal artery occlusion
  • Autoimmune disorders

Assessment

  • Assess body systems for the manifestations of CRF
  • Assess psychological changes, which could include emotional lability, withdrawal, depression, anxiety, suicidal behavior, denial, dependence- independence conflict, and changes in body image.

Interventions

  • Same as the interventions for ARF
  • Administer a prescribed diet, which is usually a moderate-protein (to decrease the workload on the kidneys) and high-carbohydrate, lowpotassium, and low-phosphorus diet.
  • Provide oral care to prevent stomatitis and reduce discomfort from mouth sores.

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