Nursing Informatics: Bachelor of Science in Nursing

BACHELOR OF SCIENCE IN NURSING:
NURSING INFORMATICS
COURSE MODULE COURSE UNIT WEEK
2 9 10
Renal Failure
✓ Read course and unit objectives

✓ Read study guide prior to class attendance
✓ Read required learning resources; refer to unit
terminologies for jargons
✓ Proactively participate in classroom discussions
✓ Participate in weekly discussion board (Canvas)
✓ Answer and submit course unit tasks
At the end of this unit, the students are expected to:
Cognitive:
1. Identify presenting signs and symptoms of clients with alteration in renal functions.
2. Discuss and apply emergency nursing management to the client with renal failure.
Affective:
1. Listen attentively during class discussions
2. Demonstrate tact and respect when challenging other people’s opinions and ideas
3. Accept comments and reactions of classmates on one’s opinions openly and graciously.
Psychomotor:
1. Participate actively during class discussions
2. Confidently express personal opinion and thoughts in front of the class
Schumacher, L., & Chernecky, C. C. (2010). Saunders nursing survival guide: critical care &
emergency nursing. St. Louis, Mo.: Elsevier Saunders.
Kidney (renal) failure is when kidneys don't work as well as they should.
It occurs when the kidneys lose the ability to sufficiently filter waste
from the blood. Many factors can interfere with the kidney health and
function.
A. Acute Tubuluar Necrosis (Acute renal failure) – frequently used

to identify common renal injuries that are results of nephrotoxic
and ischemic renal injuries
1. Causes:
a. Prerenal - represents the most common form of kidney injury (i.e. fluid depletion)
b. Intrarenal - direct damage to the kidneys causes a sudden loss in kidney function
c. Post-renal - an obstruction in the urinary tract below the kidneys causes waste to build up
in the kidneys
2. Stages:
a. Initial (hours to days) – from acute insult to signs of injury
b. Maintenance phase (1-2 weeks) – GFR continues to decrease and stabilize
c. Recovery phase (several months to years) – tubular function and GFR restoration
3. Treatment focuses on correction of underlying cause
✓ Monitoring serum electrolyte laboratory values
✓ Daily weighing
✓ Consultation with nephrologist before taking OTC drugs
B. Chronic Renal Failure –gradual progressive disorder characterized by an irreversible loss of renal
function and reduction in the GFR
1. Causes:
a. DM and hypertension are common causes
2. National Kidney Foundation Stages:
a. Stage 1 – kidney damage (no symptoms)
b. Stage 2 – mild (no or rare symptoms)
c. Stage 3 – moderate (clinical and laboratory signs)
d. Stage 4 – severe (prominent signs)
e. Stage 5 – kidney failure (uremic syndrome)
3. Treatment focuses on slowing the progression of the disease and managing symptoms
a. Dialysis
o Continuous Renal Replacement Therapy (CRRT) – refers to a variety of techniques
used to provide extracorporeal fluid or solute removal on a continuous basis
o Intermittent Hemodialysis (IHD) – also known as traditional hemodialysis;
accomplished using a machine to pump blood from the patient to a dialyzer filter
o Continuous Ambulatory Peritoneal Dialysis (CAPD) – patient’s peritoneum serves as
the semi-permeable membrane
b. Renal Transplant
Acute Renal Failure – sudden loss of the ability of kidneys to eliminate excess salts, fluids, and
waste materials from the blood; a very serious condition and requires immediate treatment
Chronic Renal Failure – a gradual loss of kidney function over time; progressive and irreversible
Emergency Nurses Association. (2019). Sheehy’s Manual of Emergency Care, 7th ed. St. Louis:
Elsevier Mosby. pp 504-593
Krishnan, M.and thiry, K. (2019 February). Innovation in dialysis: Continuous improvement and
implementation, NEJM Catalyst: Innovations in Care Delivery. Retrieved from
https://catalyst.nejm.org/doi/abs/10.1056/CAT.19.0007
Short Case Analysis: Read the scenario below and answer the questions that follow in 5-10
sentences only. Do not forget to cite your reference(s) to support/justify your answers.
The nurse is caring for Mr. Bean, 5’ tall weighing 100lbs. At the end of the 8-hour shift, the nurse
emptied Mr. Bean’s indwelling catheter bag. It has 190mL of amber-colored urine.
What will the nurse do as a PRIORITY independent intervention? Why? (Hint: Compute first for the
expected UO of the client)
Centers for Disease Control and Prevention (CDC) (n.d.).
https://www.cdc.gov/
Department of Health (Kagawaran ng Kalusugan). (n.d).

https://www.doh.gov.ph
Emergency Nurses Association. (2019). Sheehy’s Manual of Eme

rgency Care , 7th ed. St. Louis: Elsevier Mosby.
Hinkle, J. and Cheever, K. (2017). Brunner & Suddharth’s Textbook of Medical-Surgical Nursing,
14th ed. USA: Wolters Kluwer
Krishnan, M.and thiry, K. (2019 February). Innovation in dialysis: Continuous improvement and
implementation, NEJM Catalyst: Innovations in Care Delivery. Retrieved from
https://catalyst.nejm.org/doi/abs/10.1056/CAT.19.0007
Schumacher, L., & Chernecky, C. C. (2010). Saunders nursing survival guide: critical care &
emergency nursing. St. Louis, Mo.: Elsevier Saunders.

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BACHELOR OF SCIENCE IN NURSING:

✓ Read course and unit objectives

At the end of this unit, the students are expected to:

A. Acute Tubuluar Necrosis (Acute renal failure) – frequently used

Department of Health (Kagawaran ng Kalusugan). (n.d).

Emergency Nurses Association. (2019). Sheehy’s Manual of Eme

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