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Decreased Cardiac Output and Impaired Skin Integrity - NCP Chronic Kidney Disease

Nursing Care Plan for Chronic Kidney Disease

Chronic Kidney Disease (CKD) / CRF is a kidney disorder that is progressive and irreversible in which the ability of the body fails to maintain metabolism and fluid and electrolyte balance, causing uremia (retention of urea and other nitrogen garbage in the blood).

Causes of Chronic Kidney Diseas

CKD / CRF may be caused by systemic diseases are as follows:
  1. DM.
  2. Chronic Glomerulonefrtitis.
  3. Pyelonephritis.
  4. Toxic agents.
  5. Uncontrolled hypertension.
  6. Urinalysis tract obstruction.
  7. Vascular disorders.
  8. Infection.

Clinical manifestations of Chronic Kidney Disease
  1. Cardiovascular system: includes hypertension (due to fluid retention and sodium from activation of the renin-angiotensin-aldosterone system), congestive heart failure and pulmonary edema (due to excess fluid) and pericarditis (due to irritation of the pericardial layers by uremic toxins).
  2. Integrumenurum system: severe itching (pruritus). Granules is a penunpukkan uremic urine crystals in the skin, hair thin and rough.
  3. Gastrointestinal System: anorexia, nausea, vomiting.
  4. Neurovascular system: changes in the level of consciousness, inability to concentrate, and muscle spasms kedura.
  5. Pulmonary System: krekels, sputun thick, deep breath and kusmaul.
  6. Reproductive system: amenorrhea, testicular atrifi.

Nursing Diagnosis : Decreased Cardiac Output related to increased cardiac load

Goal: Decrease in cardiac output does not occur

Expected outcomes : maintain cardiac output and blood pressure with evidence of cardiac frequency in the normal range, strong peripheral pulses and capillary refill time is equal to.

1. Auscultation of heart and lungs.
R /: The presence of an irregular heart rate tachycardia.

2. Assess for hypertension.
R /: Hypertension may occur due to interference with the system of the renin-angiotensin-aldosterone system (caused by renal dysfunction).

3. Investigate complaints of chest pain, note the location, severity (0-10 scale).
R /: HT and CRF can cause pain.

4. Assess the level of activity, response to activity.
R /: Fatigue can also accompany CRF anemia.

Nursing Diagnosis : Impaired Skin Integrity related to pruritis

Goal : Skin integrity can be maintained

Expected outcomes :
Maintaining intact skin.
Shows the behavior / technique to prevent skin damage.

Intervention :
1. Inspection of the skin to change color, turgor, vascular, note any redness.
R / : Indicates areas poor circulation or damage that may lead to the formation of pressure sores / infections.

2. Monitor fluid intake and hydration of the skin and mucous membranes.
R / : Detecting the presence of dehydration or overhydration affecting circulation and tissue integrity

3. Inspection of the area depends on the edema.
R / : Tissue edema is more likely to be damaged / torn.

4. Change positions as often as possible.
R / : Lowering pressure on edema, poorly perfused tissue to reduce ischemia.

5. Give skin care.
R / : Reduce drying, skin tears.

6. Maintain a dry linen.
R / : Lowering dermal irritation and the risk of skin damage.

7. Instruct the patient to use a damp and cold compresses to put pressure on the area pruritis.
R / : Eliminate the discomfort and reduce the risk for injury.

8. Encourage wear loose cotton clothes.
R / : Prevent direct dermal irritation and improve skin moisture evaporation.