Exam 69: Immunosuppressants

A patient is started on immunosuppressant drugs after kidney transplantation and will be taking azathioprine [Imuran] as part of the drug regimen. The patient asks the nurse why it is necessary to have a specimen for a complete blood count drawn at the beginning of therapy and then periodically thereafter. The nurse explains that azathioprine can alter blood cells and tells the patient to report:

A patient with a history of lung transplantation is admitted for treatment for a respiratory infection. The patient has been taking cyclosporine [Sandimmune],prednisone,and azathioprine [Imuran] for 8 months. The provider has ordered azithromycin [Zithromax] to treat the infection and acetaminophen [Tylenol] as needed for fever. The nurse will contact the provider to:

A patient with a liver transplant has been receiving cyclosporine [Sandimmune] for 6 months. The nurse reviews this patient's laboratory results and notes a sharp increase in the blood urea nitrogen (BUN)and serum creatinine. Vital signs are normal,and the patient reports no discomfort. What does the nurse suspect?

A nurse provides teaching to a patient who has undergone kidney transplantation and will begin taking cyclosporine [Sandimmune],a glucocorticoid,and sirolimus [Rapamune]. Which statement by the patient indicates understanding of the teaching?

The nurse is caring for a 15-year-old patient who has undergone a liver transplant. Which provider order will the nurse question?

A patient who is taking azathioprine [Imuran] to prevent rejection of a renal transplant develops gout and the provider orders allopurinol. The nurse will contact the provider to discuss:

A nursing student asks the nurse how antibodies provide immune suppression. The nurse responds by telling the student that antibodies:

The nurse is preparing to administer basiliximab [Simulect] to a patient to prevent acute rejection. By which route will the nurse administer the drug?

The nurse is administering medications to a patient who is receiving cyclosporine [Sandimmune]. Which medication,when administered concurrently with cyclosporine,would warrant a reduction in the dosage of cyclosporine?

A nurse is teaching a patient who is about to undergo allograft transplantation of the liver. Which statement by the patient indicates understanding of the post-transplant medications?

A patient is taking cyclosporine [Sandimmune] and prednisone to prevent organ rejection after right renal transplantation. The patient is febrile and complains of right-sided flank pain. The nurse reviews the patient's chart and finds that the patient's BUN and serum creatinine are elevated. The cyclosporine trough is 150 ng/mL. What will the nurse do?

A patient has undergone liver transplantation. The provider orders cyclosporine [Sandimmune],prednisone,and sirolimus [Rapamune]. What will the nurse do?

The nurse knows that which immunosuppressants are among the most effective?

The nurse is caring for a patient after recent renal transplantation. The patient is taking sirolimus [Rapamune] to prevent transplant rejection. What other medications would the nurse expect the patient to be taking?