In acute kidney injury, the kidneys suddenly stop filtering well. Fluid, potassium, and waste build up. Nursing care protects the kidneys and catches dangerous electrolyte changes early.
A · AssessmentD · DiagnosisP · PlanningI · InterventionE · Evaluation
Each care plan below follows the nursing process (ADPIE).
CARE PLAN 1 · NURSING DIAGNOSIS
PLANNING · EXPECTED OUTCOMES
ASSESSMENT
Excess Fluid Volume
Related to
- Decreased kidney filtration
As evidenced by
- Low urine output
- Weight gain and edema
- Rising creatinine
Short-term goals
- Intake and output balance within 48 hours
Long-term goals
- Kidney function returns toward baseline
- Strict I&O and daily weights
- Edema and lung sounds
- Creatinine and BUN
| INTERVENTION | RATIONALE |
|---|---|
| Restrict fluids as ordered | Prevents fluid overload while the kidneys recover. |
| Avoid nephrotoxic drugs like NSAIDs and IV contrast when possible | Protects the kidneys from more damage. |
| Prepare for dialysis if ordered | Removes fluid and waste when the kidneys cannot. |
EVALUATION
- Weight and edema are decreasing
CARE PLAN 2 · NURSING DIAGNOSIS
PLANNING · EXPECTED OUTCOMES
ASSESSMENT
Risk for Electrolyte Imbalance
Related to
- Kidneys cannot excrete potassium
As evidenced by
- (Risk diagnosis)
Short-term goals
- Potassium stays within the normal range
Long-term goals
- Client is free of dysrhythmias
- Potassium and other electrolytes
- Cardiac monitor for peaked T waves
| INTERVENTION | RATIONALE |
|---|---|
| Limit potassium in diet and IV fluids as ordered | The kidneys cannot remove extra potassium. |
| Keep calcium gluconate, insulin, and dextrose available per protocol | These treat dangerous hyperkalemia. |
EVALUATION
- Potassium is normal and the rhythm is stable
Quick answers
What is an early sign of AKI?
Falling urine output, under about 0.5 mL/kg/hr, along with a rising creatinine.
For learning only. Individualize every care plan to your client, and follow your program, current guidelines, provider orders, and facility policy.