What does the nurse expect the healthcare provider to prescribe when a post-kidney transplant client develops oliguria, elevated temperature of 37.8°C, increased blood pressure, and signs of fluid retention 12 days after the surgery?

Immediate return to hemodialysis.

Immediate removal of the transplanted kidney.

Antibiotic therapy.

Increased doses of immunosuppressive drugs.

Answer and Explanation

The Correct Answer is C

Choice A reason: Immediate return to hemodialysis is not typically the first line of treatment for these symptoms. Hemodialysis is a renal replacement therapy used when the kidneys are not functioning adequately. While it may be necessary in some cases, the symptoms described suggest an infection rather than complete kidney failure.

Choice B reason: Immediate removal of the transplanted kidney is a drastic measure and is not the first step in managing these symptoms. This action would be considered only if there is clear evidence of irreversible graft failure or severe complications that cannot be managed with other treatments.

Choice C reason: Antibiotic therapy is

The correct answer. The symptoms of oliguria (low urine output), elevated temperature, increased blood pressure, and signs of fluid retention suggest an infection, which is a common complication after kidney transplantation due to the immunosuppressive medications that lower the immune system's ability to fight infections. Treating the infection with antibiotics is crucial to prevent further complications and preserve the function of the transplanted kidney.

Choice D reason: Increased doses of immunosuppressive drugs are not appropriate in this situation. While immunosuppressive drugs are essential to prevent organ rejection, increasing their dosage in the presence of an infection could further compromise the immune system and exacerbate the infection. The priority is to address the infection first.

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Correct Answer is A

Explanation

Choice A reason: Warfarin is an anticoagulant commonly used in patients with atrial fibrillation to prevent the formation of blood clots. Atrial fibrillation increases the risk of stroke due to the potential for blood clots forming in the heart and traveling to the brain. Warfarin helps reduce this risk by thinning the blood and preventing clot formation.

Choice B reason: Atropine is used to treat bradycardia (slow heart rate) and is not typically used for patients with atrial fibrillation. Its primary function is to increase the heart rate by blocking the vagus nerve's effects on the heart. In the context of atrial fibrillation, anticoagulation is more crucial to prevent complications like stroke.

Choice C reason: Dobutamine is an inotropic agent used to increase cardiac output in patients with heart failure or cardiogenic shock. It is not used for managing atrial fibrillation. Dobutamine works by stimulating the heart to pump more effectively but does not address the risks associated with atrial fibrillation, such as blood clot formation.

Choice D reason: Magnesium sulfate is used to treat various conditions, including torsades de pointes (a type of abnormal heart rhythm) and severe asthma attacks. It is not typically used for atrial fibrillation. The focus in atrial fibrillation management is on controlling the heart rate or rhythm and preventing thromboembolic complications with anticoagulation therapy.

A. Fever. B. Gray-blue discoloration of the flank or umbilical area. C. Hypertension. D. Decreased amylase level. E. Nausea and vomiting. F. Severe abdominal pain.

Correct Answer is ["A","B","E","F"]

Explanation

Choice A reason: Fever is a common sign of acute pancreatitis and indicates an inflammatory response. Inflammation of the pancreas can trigger the release of cytokines and other inflammatory mediators, leading to an elevated body temperature. This is a common symptom observed in many cases of acute pancreatitis and suggests an ongoing inflammatory process.

Choice B reason: Gray-blue discoloration of the flank or umbilical area, also known as Grey Turner's sign and Cullen's sign respectively, indicates bleeding and severe inflammation within the pancreas. These signs are indicative of retroperitoneal hemorrhage or pancreatic necrosis, which are severe complications of acute pancreatitis. The presence of such discoloration is a significant finding that suggests a more serious form of the condition.

Choice C reason: Hypertension is not typically associated with acute pancreatitis. In fact, patients with acute pancreatitis are more likely to experience hypotension due to fluid shifts, inflammatory responses, and potential hemorrhage. Monitoring blood pressure is important in these patients to manage any potential complications.

Choice D reason: Decreased amylase level is not an expected finding in acute pancreatitis. Typically, acute pancreatitis is associated with elevated levels of pancreatic enzymes such as amylase and lipase due to inflammation and damage to the pancreatic cells, which release these enzymes into the bloodstream.

Choice E reason: Nausea and vomiting are common symptoms in acute pancreatitis. The inflammation of the pancreas and the associated pain can stimulate the vomiting center in the brain and lead to nausea and vomiting. These symptoms are often severe and can significantly affect the patient's comfort and hydration status.

Choice F reason: Severe abdominal pain is one of the hallmark signs of acute pancreatitis. The pain is typically located in the upper abdomen and may radiate to the back. It is often described as constant and severe, and can be exacerbated by eating or lying flat. Effective pain management is a critical aspect of caring for patients with acute pancreatitis.

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What does the nurse expect the healthcare provider to prescribe when a post-kidney transplant client develops oliguria, elevated temperature of 37.8°C, increased blood pressure, and signs of fluid retention 12 days after the surgery?

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A nurse is caring for a patient with atrial fibrillation. In addition to an antidysrhythmic, what medication does the nurse plan to administer?

Correct Answer is A

Explanation

The emergency department nurse can expect to see which assessment cues in the patient with acute pancreatitis? Select all that apply.

Correct Answer is ["A","B","E","F"]

Explanation

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