Medical Diagnosis: Chronic Renal Failure Problem: Altered Nutrition: Less than Body Requirements RT Catabolic State, Anorexia

and Malnutrition Assessment Subjective: (none) Objective: Anorexia Anemia Fatigue Reported inadequate food intake less than recommended daily allowance (Dont forget which of the following signs and symptoms above that the patient manifested and may manifest) Nursing Diagnosis Altered Nutrition: Less than body Requirement R/T Catabolic state, Anorexia and Malnutrition 2O to Renal Failure Scientific Explanation Due restricted foods and prescribed dietary regimen, an individual experiencing renal problem cannot maintain ideal body weight and sufficient nutrition. At the same time patients may experience anemia due to decrease erythropoietic factor that cause decrease in production of RBC causing anemia and fatigue. Planning Short Term: After 6-7 hours of NI, the patient will display normalization of laboratory values and be free of signs of malnutrition. Interventions 1. Establish rapport 2. Assess general appearance and monitor vital signs. 3. Identify patient at risk for malnutrition. 4. Ascertain understanding of individual nutritional needs. 5. Assess weight, age, body build, strength, rest level. 6. Assist in developing individualized regimen. 7. Provide diet modification as indicated. Rationale 1. To gain patients trust. 2. To establish baseline data. Evaluation Short Term: The patient shall have displayed normalization of laboratory values and be free of signs of malnutrition.

Long Term: After 4-5 days of NI, the patient will demonstrate behaviors, lifestyle change to regain and maintain an appropriate weight.

3. To assess contributing factors.

4. To determine what information to provide the patient.

Long Term: The patient shall have demonstrated behaviors, lifestyle changes to regain and maintain an appropriate weight.

5. To provide comparative baseline.

6. To control underlying factors.

7. To establish a nutritional plans.

8. Determine whether patient prefers more calories in a meal. 9. Avoid high in sodium-rich food. 10. Promote relaxing environment. 11. Provide oral care. 12. Provide safety.

8. To establish a nutritional plans.

9. To prevent further increase in sodium level. 10. To enhance intake.

11. To prevent further spread of dental caries. 12. To prevent injury.

13. Maintain bed rest. 14. Change position every 2 hours.

13. To decrease metabolic demand. 14. To prevent ulcerations.

15. Position the bed into semifowlers position. 16. Limit fluid intake as ordered. 17. Encourage to

15. To enhance lung expansion.

16. To prevent water retention.

do Passive range of motion exercise. 18. Encourage early ambulation. 19. Regulate Intravenous line as Ordered. 20. Administer Medications as ordered.

17. To have proper circulation of blood.

18. To prevent muscle atrophy.

19. To maintain hydration status. 20. To prompt treatment.