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학습 자료 둘러보기 →In CKD stage 5, the kidneys have lost nearly all capacity to excrete fluid. A systemic stressor like pneumonia combined with reduced cardiac output from atrial fibrillation creates a high risk for pulmonary edema. The immediate threat is fluid overload worsening respiratory distress.
The priority nursing action is to assess fluid balance by strictly monitoring intake and output, daily weights, and lung sounds. This assessment directly informs the need for urgent interventions like dialysis, rather than administering diuretics which are ineffective in anuric patients.
Do not administer loop diuretics to a patient with CKD stage 5 without a specific order and confirmed residual renal function. The standard treatment for fluid overload in end-stage renal disease is emergent hemodialysis, not medication.
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