Chronically Elevated BUN

Care Plan for Chronically Elevated BUN

Category / Primary Body System:

Renal

Problem:

Chronically elevated BUN

Goal:

BUN will be within normal limits (WNL) on the next lab draw

Plan/Approach:

1. Laboratory Monitoring:

   • Step-by-Step Approach: Draw labs as ordered, monitor results, and report to the attending physician.
   • Rationale: Regular monitoring helps track BUN levels and adjust treatment plans promptly.

2. Dehydration Monitoring:

   • Step-by-Step Approach: Monitor each shift for signs and symptoms (s/s) of dehydration, including poor skin turgor, flushed dry skin, coated tongue, thirst, tachycardia, hypotension, oliguria, irritability, fever, and dry mucous membranes.
   • Rationale: Early detection of dehydration can prevent complications and support kidney function.

3. Immediate Notification:

   • Step-by-Step Approach: Notify the MD immediately with any s/s of dehydration.
   • Rationale: Prompt medical intervention can address dehydration before it exacerbates kidney issues.

4. Intake and Output Monitoring:

   • Step-by-Step Approach: Monitor intake and output as ordered (A/O).
   • Rationale: Tracking fluid balance is critical for managing BUN levels and ensuring adequate hydration.

5. Fluid Intake Encouragement:

   • Step-by-Step Approach: Offer fluids per dietary estimated fluid need and encourage intake per this estimation.
   • Rationale: Adequate hydration helps reduce BUN levels by supporting kidney function.

6. Dietary Collaboration:

   • Step-by-Step Approach: Keep the dietitian informed of intake.
   • Rationale: Coordinating with the dietitian ensures dietary adjustments support overall treatment goals.

7. Electrolyte Imbalance Monitoring:

   • Step-by-Step Approach: Monitor closely for s/s of electrolyte imbalance.
   • Rationale: Maintaining electrolyte balance is crucial for preventing complications related to elevated BUN.

Actions:

1. Laboratory Monitoring:

   • Staff will draw labs as ordered, monitor results, and report to the attending physician.

2. Dehydration Monitoring:

   • Staff will monitor each shift for s/s of dehydration, including poor skin turgor, flushed dry skin, coated tongue, thirst, tachycardia, hypotension, oliguria, irritability, fever, and dry mucous membranes.

3. Immediate Notification:

   • Staff will notify the MD immediately with any s/s of dehydration.

4. Intake and Output Monitoring:

   • Staff will monitor intake and output A/O.

5. Fluid Intake Encouragement:

   • Staff will offer fluids per dietary estimated fluid need and encourage intake per this estimation.

6. Dietary Collaboration:

   • I will keep the dietitian informed of my intake.

7. Electrolyte Imbalance Monitoring:

   • Staff will monitor closely for s/s of electrolyte imbalance.