Question 1

The patient tells the nurse that he understands that transplant rejection may happen and asks what can be done to minimize risk of rejection and other negative outcomes. What will the nurse include in the teaching?

A) "An anti-T-cell antibody should be used in conjunction with corticosteroid therapy for best results."
B) "ATG rabbit started immediately after transplant can help prevent rejection."
C) "Transplant rejection drugs can be used and while they have unwanted side effects, none are deadly."
D) "Caution needs to be taken when other immunosuppressant drugs are administered to avoid serious infections."

Accepted Answer

The use of immunosuppressant drugs is the mainstay of preventing transplant rejection, but caution is necessary because these drugs also increase the risk of infections. Therefore, monitoring for signs of infection and adjusting the dosage of medication is necessary to avoid serious complications. The other choices (A and B) are specific treatments and not general principles of transplant rejection prevention. The statement in choice C about the side effects of transplant rejection drugs is not entirely accurate, as some of the side effects can be life-threatening.

Question 2

Combination of corticosteroids with certain antibiotics can result in which of the following?&#10;A) Increased risk of QT prolongation and arrhythmias&#10;B) Increased risk of hypokalemia&#10;C) Increased risk of hyperglycemia&#10;D) Increased risk of ophthalmic toxicity

Accepted Answer

Corticosteroids can increase the risk of QT prolongation and arrhythmias, especially when combined with certain antibiotics such as erythromycin or azithromycin.

Question 3

The nurse is teaching a patient who will begin taking basiliximab in conjunction with a kidney transplant. Which of the following would be appropriate to include when counseling the patient?&#10;A) The drug is used to boost the immune system.&#10;B) The drug is taken by mouth before and after the transplant surgery.&#10;C) Nausea, vomiting, fever, and chills are common side effects.&#10;D) Basiliximab is primarily used for patients receiving a heart transplant.

Accepted Answer

Basiliximab is an immunosuppressive agent used to prevent organ rejection in patients undergoing kidney transplants. It does not boost the immune system but rather suppresses it to prevent the body from attacking the transplanted organ. It is administered intravenously, not orally, and is specifically used for kidney transplants, not primarily for heart transplants. Nausea, vomiting, fever, and chills are indeed common side effects associated with its use.

Question 4

Your patient is taking belatacept and develops posttransplant lymphoproliferative disorder (PTLD). PTLD primarily affects:&#10;A) the liver&#10;B) the heart&#10;C) the kidneys&#10;D) the nervous system

Accepted Answer

PTLD primarily affects the lymphoid tissues, which can manifest in various parts of the body, including the nervous system. It is a significant complication associated with immunosuppressive drugs like belatacept, used to prevent organ rejection in transplant patients.

Question 5

A patient who has had an organ transplant is prescribed cyclosporine for maintenance therapy. Which statement by the patient indicates further teaching is needed?&#10;A) &#34;I will have to have blood tests drawn regularly while taking this medication.&#34;&#10;B) &#34;I should avoid drinking grapefruit juice while on this medication.&#34;&#10;C) &#34;I have to avoid receiving live vaccines.&#34;&#10;D) &#34;Cyclosporine does not enter breast milk so there are no concerns with breast feeding.&#34;

Accepted Answer

Cyclosporine is excreted in breast milk, so it is not recommended for breastfeeding mothers. The other statements are correct and indicate that the patient has some understanding of the medication and its requirements.

Deck 30: Transplant Drugs