The nurse is caring for a patient 22 hours after undergoing kidney transplantation. The patient develops hyperacute rejection of the transplanted kidney. What intervention will the nurse anticipate for this patient at this time?

Removal of the transplanted kidney.

An increase in the dose of cyclosporine therapy.

A new kidney transplant from a living donor.

Administration of methylprednisolone sodium succinate.

Answer and Explanation

The Correct Answer is A

Choice A reason: Removal of the transplanted kidney is the definitive intervention for hyperacute rejection. Hyperacute rejection occurs within minutes to hours after transplantation due to pre-formed antibodies against the donor organ. This form of rejection is irreversible and requires immediate removal of the transplanted kidney to prevent further complications and damage to the recipient's health.

Choice B reason: An increase in the dose of cyclosporine therapy is not effective in hyperacute rejection. Cyclosporine is an immunosuppressive medication used to prevent rejection, but in cases of hyperacute rejection, the rapid and severe immune response cannot be controlled by increasing the dose. The affected kidney must be removed.

Choice C reason: A new kidney transplant from a living donor is not an immediate intervention for hyperacute rejection. Before considering another transplant, it is essential to identify and address the underlying cause of hyperacute rejection and ensure that the recipient's immune system is adequately managed to prevent recurrence.

Choice D reason: Administration of methylprednisolone sodium succinate is typically used to manage acute rejection episodes but is not effective for hyperacute rejection. The rapid onset and severity of hyperacute rejection necessitate the removal of the transplanted organ rather than relying on immunosuppressive medications.

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Correct Answer is B

Explanation

Choice A reason: Notifying the blood bank of the suspected transfusion reaction is important, but maintaining the IV access with normal saline infusion takes priority to ensure that the patient remains stable and to prevent any further complications.

Choice B reason: Maintaining IV access with normal saline infusion is the first priority. This action helps to keep the vein open, provide fluids, and flush out any remaining blood product from the IV line, reducing the risk of further reaction.

Choice C reason: Facilitating the transfer of the patient to the critical care unit may be necessary if the patient's condition worsens, but it is not the immediate first step.

Choice D reason: Rechecking identification labels and numbers is important to confirm the correct blood product was given, but it comes after ensuring the patient’s stability by maintaining IV access with saline.

A. "Abdominal ultrasound should not be performed if you are pregnant." B. "Guaiac-based faecal occult blood testing is a non-invasive test that is commonly performed." C. "You will have to remove any device containing metal for a flexible sigmoidoscopy." D. "The radiologist will perform the hydrogen breath test under general anaesthesia to protect your airway."

Correct Answer is B

Explanation

Choice A reason: "Abdominal ultrasound should not be performed if you are pregnant" is incorrect. Abdominal ultrasound is a safe and non-invasive diagnostic test that can be performed during pregnancy without any risk to the patient or the fetus.

Choice B reason: "Guaiac-based fecal occult blood testing is a non-invasive test that is commonly performed" is correct. This test is used to detect hidden blood in the stool and is commonly used for diagnostic purposes in patients with irritable bowel syndrome (IBS). It is safe and non-invasive.

Choice C reason: "You will have to remove any device containing metal for a flexible sigmoidoscopy" is correct but does not address the safety concern regarding IBS. Patients do need to remove metal objects for certain diagnostic procedures, but the focus should be on providing information about the non-invasive nature of specific tests.

Choice D reason: "The radiologist will perform the hydrogen breath test under general anesthesia to protect your airway" is incorrect. Hydrogen breath tests are typically performed without anesthesia. Patients simply need to blow into a device at specific intervals after ingesting a substance. The test is non-invasive and does not require anesthesia.

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The nurse is caring for a patient 22 hours after undergoing kidney transplantation. The patient develops hyperacute rejection of the transplanted kidney. What intervention will the nurse anticipate for this patient at this time?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is B

Explanation

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Correct Answer is B

Explanation

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