Unit 9 CHPT 63 Kidney Replacement, CHPT 53 Liver Replacement, CHPT 32 Heart Replacement , CHPT 27 Lung Replacement

Question 1

Kidney Transplant Rejection s/s

Answer 1

Hyperacute Rejection:within 48 hours of transplant
* hyperthermia
* hypertension
* pain at transplant site
TREATMENT
* Immediate removal of the transplanted kidney

Acute Rejection:occurs over weeksMOST COMMON
*Oliguria
* Temp greater than 100F
*Fluid retension
*Enlarged ,tender Kidney
*Lethargy
*High Bun
*High creatnin\

TREATMENT
*Increase dose of immunosupressive drugs

Chronic Rejection:occurs over months and years
*Changes in electroye levels
*fatigue
*fluid retension

hypotension or diuresis
* Hypotension=KIDNEY FAILURE

hypotension or diuresis
* Hypotension=FAILURE

Notify MD for

Question 2

Lung Transplant Rejection s/s

Answer 2

*crackles
*productive cough with green or yellow sputum/sign of infection
*Diaphoresis
*Dyspnea
Major problems after lung transplantation are bleeding, infection, and transplant rejection. The patient usually remains in the ICU for several days after transplantation. Postoperative chest physiotherapy often is performed with high-frequency chest wall oscillation (HFCWO) at this time.

Question 3

Heart Transplant Rejection s/s

Answer 3

heart failure symptoms

• Shortness of breath
• Fatigue
• Edema
• Fluid gain: 3 pounds in a day or week
• Abdominal bloating
  *New onset of bradycardia, A-fib, A-flutter
• Hypotension
• • Decreased activity tolerance
• Decreased ejection fraction (late sign) Norma range is 50-70

Question 4

Liver Transplant Rejection s/s

Answer 4

tachycardia,
fever,
pain in the right upper quadrant or flank,
*decreased bile pigment and volume, and
increasing jaundice.

INCREASED Laboratory findings include
Serum bilirubin
-Total: 0.3-1 mg/dL
Indirect: 0.2-0.8 mg/dL
Direct: 0.1-0.3 mg/dL

ALT: Both Sexes: 4-36 IU/mL

AST: 0-35 IU/L

alkaline phosphatase: 30-120 IU/L

PT: 11-12.5

INR: 0.9-1.2

Question 5

What can cause an acute reaction

Answer 5

• nonadherenace to immunosupressant medications

Question 6

Should organ replacement patients take immmunosuppressants for life?
A. no
B. yes

Answer 6

B. yes

MEDICATIONS FOR ORGAN TRANSPLANT RECIPIENTS
* Cyclosporin (Gengraf)
* Corticosteroids
* Tacrolimus (Prograf)
* Sirolimus (Rapamune)

• Prevent organ rejection
• Azathioprine (Imuran)
• Methotrexate
• Cyclophosphamide (Cytoxan)