Planning the Nursing Care
- Monitor fluid intake and urinary output
- Administer drugs as advised/prescribed
- Monitor the child on dialysis
- Provide therapeutic diet
- Prevent complications
- Protect the child from infection.
Implementation of Nursing Care
Monitor Fluid Intake and Output
It is your responsibility as a nurse to maintain strict intake and output and daily weight record. In a child with complete anuria, daily
intake is restricted to losses through perspiration, vomiting, stools and breathing. This may be given orally or intravenously as advised : Avoid excessive intake of fluids to prevent volume overload.
IV isotonic saline or ringer's lactate is given at the rate of 20 to 30 ml/kg of body weight in one hour. In case of excessive blood loss or burns, a blood transfusion (10 to 20 mg/kg is indicated).
Administration of Drugs as Prescribed
If the output of urine does not increase despite adequate rehydration mannitol may be given as advised. It is given in the dose of 0.2 to 0.5 g/kg of a 20 per cent aqueous solution intravenously during 3 to 5 minutes interval. If response to mannitol is also poor, a diuretic like frusemide may be advised.
Therapeutic Diet
Protein intake is reduced to a minimum to cut down endogenous catabolism. Diet should be mainly in the form of carbohydrates and fats.