Acute Renal Failure (ARF): Nursing Interventions


Acute renal failure (ARF) occurs as a result of a breakdown in the functioning of the renal due to kidney damage. Subsequently, the kidney may retain excessive quantities of harmful nitrogenous and non-nitrogenous wastes associated with renal failure. This analytical treatise attempts to explicitly present an outline for nursing intervention to prevent complications in the patient with ARF.

Nursing interventions

Side effects of different electrolyte imbalances

The electrolyte imbalances may lead to ineffective perfusion of the renal tissues, infection, excessive fluid volume, and a potential risk for fluid volume deficient. As a result, the renal function may be compromised and eventually lead to kidney failure. For instance, an imbalance in the protein may increase levels of sodium and affect the urine specific gravity. On the other hand, instability in the hemoglobin and erythrocytes may increase the partial thromboplastin time which consequently increases the risk of infection. As a result, the blood flow to the kidney may diminish (Arvin 2011).

A nursing intervention to minimize blood loss

It is important to know the type of ARF a patient is suffering from. It is imperative to maintain the patients at rest and increase the periods of complete rest to minimize the metabolic rate which increases the activities in the kidney. The nurse should then make frequent observations for metabolic acidosis to be in a position to notice any complications on an hourly basis. Regulate the fluid intake to avoid the occurrence of edema (Arvin 2011).

It is important to provide “oral hygiene to the patient to minimize the occurrence of ulcers and irritation of the tissues as a result of excessive acidic wastes excreted through mucous membranes” (Arvin 2011, par. 6). Moreover, this practice should go hand in hand with peritoneal dialysis and hemodialysis to minimize blood loss. In addition, the nursing intervention should incorporate counseling and guiding patients to minimize anxiety. Excessive anxiety may increase the blood loss since the renal function will be more rapid than the kidney of the patient can handle. Increased activities or excessive pressure as a result of stress or anxiety may increase the retention of the harmful wastes in the kidney of the ARF patient (Arvin 2011).

Nursing intervention and diet

The nurse should ensure that the diet of the patient has a high carbohydrate content, relatively low protein, and adequate fats since high fat and carbohydrate calories from metabolism do not support the creation of energy from proteins. This ensures that any available protein is reserved for the repair of damaged tissues. Besides, it is important to reduce quantities of food rich in potassium to minimize the high levels of potassium in the ARF patient. The high level of potassium in the renal system is very harmful since it may result in electrolyte imbalances (Arvin 2011).

Teaching plan for a patient with ART

Explaining each stage of treatment and intervention to the patients may greatly reduce any anxiety the patient is experiencing. This may also involve an assessment of the patient’s emotional status and explaining the most essential practices to minimize stress. The patient may be advised on the types of exercise to do and the frequency of each exercise. During the teaching process, the nurse may describe the ideal dental hygiene practice and the types of gums to chew to increase salivary flow. The last element that may be covered is lessons on the prevention of infections and a healthy lifestyle to minimize chances of recurrence of ARF after treatment (Winnick, Lucas, Hartman, and Toll 2005).


Arvin, A. (2011). Nursing care plan for acute renal failure. Web.

Winnick, S., Lucas, D.O., Hartman, A.L., & Toll, D. (2005). How do you improve compliance? Pediatrics, 115 (6), 718-724.

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