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 D

Explanation

Choice A reason: The statement "Headaches can occur due to the vasoconstriction effect of the medication" is incorrect. Nitroglycerin causes vasodilation, not vasoconstriction. Vasodilation increases blood flow, which can lead to headaches as a common side effect.

Choice B reason: Offering Morphine to manage the headache is not the most appropriate initial response. While Morphine can relieve pain, it's essential to educate the patient about the common side effects of Nitroglycerin and provide reassurance. Morphine use should be carefully considered and is typically reserved for more severe pain management.

Choice C reason: Notifying the physician immediately is not necessary in this scenario, as a headache is a known and common side effect of Nitroglycerin. It's more appropriate to educate the patient about the side effects and provide reassurance. Only if the headache is severe and unrelieved by other measures should the physician be notified.

Choice D reason: Explaining that the headache is a normal side effect of Nitroglycerin, which dilates blood vessels, is the most appropriate response. This helps to reassure the patient and provides an understanding of why the headache is occurring. Nitroglycerin works by dilating blood vessels to improve blood flow and reduce angina symptoms, and headaches are a common side effect due to this vasodilation.

A. Keep the head of the bed elevated at least 30 degrees. B. Administer ordered antibiotics as scheduled. C. Hyperoxygenate the patient before suctioning. D. Suction the airway every 2 hours.

Correct Answer is A

Explanation

Choice A reason: Keeping the head of the bed elevated at least 30 degrees is crucial in preventing ventilator-associated pneumonia (VAP). Elevating the head of the bed reduces the risk of aspiration of gastric contents and oral secretions into the lungs, which can lead to infection. This positioning helps improve lung expansion and facilitates drainage, thereby decreasing the likelihood of VAP.

Choice B reason: Administering ordered antibiotics as scheduled is important for treating existing infections but is not a primary preventive measure for ventilator-associated pneumonia. While antibiotics play a role in managing infections, the focus here is on preventive strategies. Overreliance on antibiotics can also lead to antibiotic resistance, making infection control more challenging.

Choice C reason: Hyperoxygenating the patient before suctioning is a standard practice to prevent hypoxia during the procedure, but it is not directly related to preventing ventilator-associated pneumonia. While hyperoxygenation helps maintain adequate oxygen levels, it does not address the specific risk factors associated with the development of VAP.

Choice D reason: Suctioning the airway every 2 hours may be necessary for some patients to maintain airway patency and remove secretions. However, routine suctioning at fixed intervals is not always appropriate and can increase the risk of trauma to the airway and infection. Suctioning should be performed based on clinical assessment and the patient's needs rather than a fixed schedule to prevent complications and potential infections.

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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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Naxlex Comprehensive Predictor Exams

A patient with angina is receiving Nitroglycerin and begins to complain of a severe headache. What is the most appropriate response from the nurse?

Correct Answer is D

Explanation

The nurse is caring for a patient with emphysema and respiratory failure who is receiving mechanical ventilation through an endotracheal tube. To prevent ventilator-associated pneumonia (VAP), which action is most important to include in the plan of care?

Correct Answer is A

Explanation

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