Preventive Measures
- Identify patients with preexisting renal disease.
- Initiate adequate hydration before, during, and after any procedure requiring NPO status.
- Avoid exposure to nephrotoxins. Be aware that the majority of drugs or their metabolites are excreted by the kidneys.
- Monitor chronic analgesic use some drugs may cause interstitial nephritis and papillary necrosis.
- Prevent and treat shock with blood and fluid replacement. Prevent prolonged periods of hypotension.
- Monitor urinary output and CVP hourly in critically ill patients to detect onset of renal failure at the earliest moment.
- Schedule diagnostic studies requiring dehydration so there are rest days, especially in aged who may not have adequate renal reserve.
- Pay special attention to draining wounds, burns, and so forth, which can lead to dehydration and sepsis and progressive renal damage.
- Avoid infection; give meticulous care to patients with indwelling catheters and I.V. lines.
- Take every precaution to make sure that the right person receives the right blood to avoid severe transfusion reactions, which can precipitate renal complications.
Corrective and Supportive Measures
- Correct reversible causes of acute renal failure (eg, improve renal perfusion; maximize cardiac output, surgical relief of obstruction).
- Be alert for and correct underlying fluid excesses or deficits.
- Correct and control biochemical imbalances treatment of hyperkalemia.
- Restore and maintain blood pressure.
- Maintain nutrition.
- Initiate hemodialysis, peritoneal dialysis, or continuous renal replacement therapy for patients with progressive renal failure and other life-threatening complications.
Patient teaching & home health guidance for patient with renal failure acute
- Explain that the patient may experience residual defects in kidney function for long period after acute illness.
- Encourage reporting for routine urinalysis and follow-up examinations.
- Advise avoidance of any medications unless specifically prescribed.
- Recommend resuming activity gradually because muscle weakness will be present from excessive catabolism.
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