Exam 21: Solid Organ Transplantation

The nurse is caring for a renal transplant recipient in the post-anesthesia care unit.Blood pressure is 125/70 mm Hg; heart rate is 115 beats/min; respiratory rate is 24 breaths/min; oxygen saturation (SpO₂)is 95% on 3 L/min of oxygen via nasal cannula,temperature is 97.8° F,and the central venous pressure (CVP/RAP)is 2 mm Hg.What is the best action by the nurse?

The nurse is caring for a postoperative renal transplant recipient in the critical care unit.After seeing minimal urine output in the catheter for most of the day,the patient expresses concern to the nurse.What is the best response by the nurse?

The nurse is caring for a renal transplant patient admitted with an acute rejection episode.The patient asks the nurse how the doctors will know if the kidney has been rejected.What is the best response by the nurse?

The transplant clinic social worker is completing a social history on a patient with end-stage renal disease who is being evaluated for transplant.Which statement by the patient warrants further action?

The charge nurse of a transplant unit is reviewing the clinical course of several transplant patients being cared for in the unit.Which patient assessed by the charge nurse requires immediate action?

The transplant clinic nurse is educating a patient about the renal criteria that must be met in order to be placed on the transplant waiting list.Which statement by the patient best indicates an understanding of the criteria?

A renal transplant recipient presents to the outpatient transplant clinic with blood glucose values for the past 3 days exceeding 250 mg/dL.The patient takes prednisone 5 mg daily and tacrolimus (Prograf)2 mg twice daily.Hemoglobin A1C level drawn the day of the clinic appointment was 8.5%.What is the best interpretation of this finding by the nurse?

The nurse is providing preoperative care to a patient who will receive a transplant.The patient has high panel reactive antibodies ( PRA ).As part of induction therapy for this patient,the nurse understands which medication to be of priority for administration in the operating room?

The nurse is preparing to admit a patient with heart failure who has been listed on the UNOS transplant list as status 1A.What is the best understanding of this classification by the nurse?

The nurse is educating a renal transplant patient about his immunosuppressant medication therapy.Which statement by the patient best indicates an appropriate understanding?

The nurse is caring for a patient in the critical care unit who,after being declared brain dead,is being managed by the OPO transplant coordinator.Thirty minutes into the shift,assessment by the nurse includes a blood pressure 75/50 mm Hg,heart rate 85 beats/min,and respiratory rate 12 breaths/min via assist/control ventilation.The oxygen saturation (SpO₂)is 99% and core temperature 93.8° F.Which physician order should the nurse implement first?

The nurse is working for a hospital that holds an agreement with a local organ procurement organization (OPO).The patient has a Glasgow Coma Scale (GCS)score of 3 and discussions have been held with the family about withdrawing life support.Which statement by the nurse best describes requirements that must be met to sustain Centers for Medicare and Medicaid Services (CMS)Conditions of Participation?

A family member approaches the nurse caring for their gravely ill son and states,"We want to donate our son's organs." What is the best action by the nurse?

The family of a critically ill patient has asked to discuss organ donation with the patient's nurse.When preparing to answer the family's questions,the nurse understands which concern(s)most often influence a family's decision to donate? (Select all that apply.)

The postanesthesia care unit receives handoff communication from the CRNA indicating that the renal transplant recipient received induction therapy in the operating room with antithymocyte globulin (ATG).What is the best understanding of the administration of this drug by the nurse?