This article shall address the proper management of a patient suffering from ESKD, focusing from the time of admission to discharge (Dalrymple et al. 2011).Nursing need assessment tool is one of the tools that shall be employed to develop the patient profile and assist in the plan for her management. This tool is very essential in addressing the needs of an older patient who require long-term care due to a chronic condition. The tool addresses the patient holistically and embraces professional decision-making. In addition, the tool makes the assessment in a staged approach by deviating from the conventional narrative approach to a focused assessment approach. Another tool that shall be employed is the nursing care plan, which shall help in addressing the patient problem and plan the management accordingly.The key health problems for CherylWarra Allen are the renal failure, hypertension and diabetes mellitus. These health problems are prioritised in that order because of their impact on the health status of the patient. Kidney failure has got a fatal result if not urgently managed this is because it leads to accumulation of several toxic wastes as well as fluid in the body. Accumulation of nitrogenous waste and urea in the blood leads to uraemia, which is a fatal cause of confusion and coma in patients with kidney failure. In addition, the state of the patient confusion makes it difficult to treat the patient since the patient shall not cooperate during the treatment process. The patient may remove the gas mask or other intravenous medication that she is being given. Renal failure leads to accumulation of fluid in the body, which is as a result of inadequate excretion of fluid by the kidney. Accumulation of fluid in the body leads to adverse effect such as difficulty in breathing. When fluid accumulates on around the lungs and adnexa tissues, the lungs and the diaphragm may get compressed leading to shallow breathing and ultimately lead to exertion. Excess accumulation within the pleural cavity leads to excess difficulty in breathing and the patient shall require a gas mask or other assisted breathers otherwise the patient can die within a short time due to shortness of breath.