Nokea
When administering cyclosporine, the nurse notes that allopurinol is also ordered for the patient. What is a potential result of this drug interaction?
- A. Reduced adverse effects of the cyclosporine
- B. Increased levels of cyclosporine and toxicity
- C. Reduced uric acid levels
- D. Reduced nephrotoxic effects of cyclosporine
Correct Answer: B
Rationale: Allopurinol may cause increased levels of cyclosporine, and toxicity may result.
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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 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.
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.
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.
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.