Nokea
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.
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A patient who has had a recent organ transplant is taking sirolimus as part of the immunosuppressant therapy. Today, the patient realized that a dose was missed, and it is now time for the next dose. Which action is appropriate?
- A. Just take the dose that is now due, not both doses.
- B. Take the missed dose of sirolimus along with the next dose that is due.
- C. Take half of the missed dose along with the current dose that is due.
- D. Contact the transplant physician for instructions.
Correct Answer: D
Rationale: If a dose of sirolimus is missed, it should be taken as soon as the patient remembers, unless it is close to the time that the next dose is due. In this case, the patient must contact the transplant physician.
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.
The nurse is preparing to administer an injection of monoclonal antibodies. Which additional drug will the nurse administer to minimize adverse reactions to the monoclonal antibodies?
- A. A nonsteroidal anti-inflammatory drug
- B. A benzodiazepine
- C. An opioid pain reliever
- D. A corticosteroid
Correct Answer: D
Rationale: The monoclonal antibodies such as basiliximab and daclizumab have a tendency to cause the allergy-like reaction known as cytokine release syndrome, which can be severe and even involve anaphylaxis. An injection of a corticosteroid, such as methylprednisolone, is recommended before the injection of monoclonal antibodies to avoid or alleviate this problem.
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.
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.