Which nursing diagnosis is included in the plan of care for this patient with ESRD?

• A. Excess fluid volume
• B. Acute pain
• C. Infection risk
• D. Pain management deficit

Answer: (A)

Managing fluid balance is central in ESRD. When the kidneys can no longer excrete fluid, the patient is at high risk for excess fluid volume, leading to edema, hypertension, weight gain, and possible pulmonary congestion. The plan of care thus prioritizes preventing and treating fluid overload through accurate I&O and daily weights, fluid and sodium restrictions, monitoring lung sounds and edema, and using dialysis as prescribed to remove excess fluid. While infection risk and pain may be considerations in certain contexts (such as access-related issues or if pain is present), they are not the primary, routinely addressed nursing diagnosis for ESRD in general care.