Nokea
A patient is about to undergo a kidney transplant. She will be given an immunosuppressant drug before, during, and after surgery to minimize organ rejection. During the preoperative teaching session, which information will the nurse include about the medication therapy?
- A. Several days before the surgery, the medication will be administered orally.
- B. The oral doses need to be taken 1 hour before meals to maximize absorption.
- C. Mix the oral liquid with juice in a disposable Styrofoam cup just before administration.
- D. Intramuscular injections of the medication will be needed for several days.
Correct Answer: A
Rationale: Several days before transplant surgery, immunosuppressant drugs need to be taken by the oral route, if possible, to avoid intramuscular injections and the risk for infection caused by the injections. Avoid Styrofoam containers because the medication may adhere to the side of the container. These medications are taken with food to minimize gastrointestinal upset.
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The nurse is monitoring a patient who is receiving mycophenolate after an organ transplant. Which adverse effect is possible with mycophenolate therapy?
- A. Constipation
- B. Hypertension
- C. Confusion
- D. Dysuria
Correct Answer: B
Rationale: Common adverse effects of mycophenolate include hypertension, hypotension, peripheral edema, tachycardia, chest pain, and other effects.
When monitoring a patient who is on immunosuppressant therapy with azathioprine, the nurse will monitor which laboratory results?
- A. Serum potassium levels
- B. White blood cell (leukocyte) count
- C. Red blood cell count
- D. Serum albumin levels
Correct Answer: B
Rationale: Leukopenia is a potential adverse effect of azathioprine therapy, so white blood cells need to be monitored.
A patient has started azathioprine therapy as part of renal transplant surgery. The nurse will monitor for which expected adverse effect of azathioprine therapy? (Select all that apply.)
- A. Tremors
- B. Leukopenia
- C. Diarrhea
- D. Thrombocytopenia
- E. Hepatotoxicity
- F. Fluid retention
Correct Answer: B,D,E
Rationale: Leukopenia is an expected adverse effect of azathioprine therapy, as are thrombocytopenia and hepatotoxicity.
Cyclosporine is prescribed for a patient who had an organ transplant. The nurse will monitor the patient for which common adverse effect?
- A. Nausea and vomiting
- B. Fever and tremors
- C. Agitation
- D. Hypertension
Correct Answer: D
Rationale: Moderate hypertension may occur in patients taking cyclosporine.
A patient will be on a tacrolimus infusion after receiving a liver transplant. The order reads, 'Give 0.03 mg/kg/day as a continuous IV infusion.' The patient weighs 211 pounds, and the medication injection solution is available in a 5 mg/mL strength. Identify how many milliliters will the nurse draw up for this infusion. (Record answer using two decimal places.)
Correct Answer: 0.58 mL
Rationale: Convert pounds to kilograms: 211 ?· 2.2 = 95.91 kg. Calculate dose: 0.03 mg/kg/day ?? 95.91 kg = 2.8773 mg/day. Calculate volume: 2.8773 mg ?· 5 mg/mL = 0.57546 mL, rounded to 0.58 mL.