Admission Care Plan

Resident: __________________________ Date: ____________________ Problem/Need: Acute Renal Failure.

Goal: Resident will have adequate I&O, no SOB or edema Approach: Monitor intake/output as ordered Monitor physical examinations to include tissue turgor, pallor, alteration in mucous, membranes, blood pressure, heart rate changes, pulmonary and peripheral edema Monitor for complications such as infection, electrolyte abnormalities, and for multiple organ systems failure Weigh pt daily or as ordered Adjust fluid intake to avoid volume overload and dehydration Inspect neck vein for engorgement and ext, abdomen, sacrum, and eyelids for edema Monitor for s/s of hyperkulemia, diarrhea, intestinal colic, irritability, nausea, parasthesis, flaccid paralysis Ausculatate lung fluids for rales

Nurse Signature _______________________________ Date___________ Resolved Date ________________________________________________