A client with rapidly progressing end-stage renal disease (ESRD) asks about the possibility of a kidney transplant. In responding to the client, the nurse understands that which of the following is a contraindication for receiving a kidney transplant?
Controlled hypertension
Alcohol abuse 3 years ago
Refractory cardiovascular disease
Hepatitis C infection
The Correct Answer is C
Hypertension is a risk factor for kidney disease. However, it can often be managed with medication. Controlled hypertension is not typically a contraindication for a kidney transplant.
B. If the client has maintained sobriety for a significant period, it might not be a contraindication. A history of alcohol abuse would require careful evaluation but doesn't necessarily preclude transplantation.
C. This is a contraindication for kidney transplantation. Severe heart disease can significantly increase the risks associated with surgery and post-transplant care.
D. Hepatitis C can be a challenge but it's not an absolute contraindication. Many transplant centers have protocols for managing hepatitis C-positive recipients.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Hematocrit measures the proportion of blood volume that is occupied by red blood cells. Epoetin alfa stimulates red blood cell production, so a therapeutic effect would be indicated by an increase in hematocrit levels. This is a key laboratory result to monitor when assessing the effectiveness of epoetin alfa in treating anemia in CKD patients.
B. Serum potassium levels are important to monitor in CKD patients due to the risk of hyperkalemia, but they are not directly affected by epoetin alfa. Decreasing serum potassium is not a primary indicator of the therapeutic effect of epoetin alfa.
C. Platelet count measures the number of platelets in the blood, which are crucial for blood clotting. Epoetin alfa is not designed to affect platelet counts; thus, a change in platelet count is not an indicator of the medication's therapeutic effect.
D. White blood cell count reflects the immune system's status and is not directly influenced by epoetin alfa. This medication specifically targets red blood cell production and does not impact white blood cell counts.
Correct Answer is B
Explanation
A. Calcium gluconate is used to treat or prevent calcium deficiencies and to manage conditions related to calcium imbalances, such as hypocalcemia. It is not typically used to prevent struvite stones.
B. Antibiotics are the most appropriate choice for preventing the recurrence of struvite stones. Since struvite stones are associated with urinary tract infections caused by urease-producing bacteria, antibiotic therapy is aimed at eliminating these infections. By treating or preventing UTIs, the conditions that lead to struvite stone formation are addressed, reducing the likelihood of recurrence.
C. Tamsulosin is an alpha-blocker used to relax the muscles in the prostate and bladder neck to improve urine flow in conditions like benign prostatic hyperplasia (BPH). It is not specifically used for preventing struvite stones.
D. Phosphate binders are used to reduce phosphate levels in the blood, which is important in managing conditions such as chronic kidney disease (CKD) where phosphate levels can be elevated.
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