Kidney is vital organ for producing urine and at the same time discharging metabolic wastes and toxins out of the body. We know that renal failure patients often have significantly reduced urine output since the kidneys are damaged and renal functions are affected. However renal failure also has a polyuric phase in which 24-h urine volume can be up to 3000-6000ml.
Is this a good thing or bad thing? First let’s learn why renal failure can cause diuresis. This means that renal tubules are damaged. Under normal circumstances, the majority of fluid and some micromolecular substances in the blood (of cause including metabolic wastes) will be filtered out the glomeruli, but 70% fluids and some useful substances will be re-absorbed in renal tubules. So if renal tubules are damaged, these fluids will directly flow away.
It is usually a good sign to have increased urine output for renal failure patients, but the problem in this condition is that the fluids are mostly water without much wasteful products in it because the blood volume that is filtered by renal glomeurli is actually greatly reduced because of glomerular damages. That is to say, the accumulation of metabolic wastes still exist though urine volume is increased.
What are the nursings for kidney patients on polyuric phase
In polyuric phase, many electrolytes like sodium, potassium, chlorine will be lost along with increased urination. Patients are easy to develop electrolyte disorders and dehydration, therefore proper nursing is very important.
Have close and regular monitoring of blood sodium and blood potassium level as well as blood pressure.
Have proper supplement of water, sodium and potassium under the doctor’s guidance to prevent hypokalaemia, hyponatremia or dehydration.
Provide adequate calories and vitamins. Protein intake can be gradually increased to meet the needs of the tissues.
Pay attention to sanitation and prevent various infections, upper gastrointestinal hemorrhage and cardiovascular complications.
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