الثلاثاء، 26 يونيو 2018

93-liver transplant

About
Either partial or full liver transplanted from one donor to another recipient via surgery.
Assess
VS, wound, Alk phos, Bilirubin, drainage characteristics, urine output; assess pain
Complications
  • Acute Graft rejection- immunosuppressive therapy increased, s/s include tachy, fever, jaundice, changes in biliary drainage, elevated bilirubin, alk phosphatase.
  • Infection- fever, foul smelling drainage from incision, t-tube, urine.
  • Abscess; acute renal failure
  • Transplant rejection; infection
Diagnosis
Ineffective protection related to induced immunosuppression
Decisional conflict related to acceptance of a donor liver
Goals
The client will be free from infection.
The client will be free from s/s indicating rejection of new organ.
Interventions
  • Monitor for s/s of rejection.
  • Monitor VS post-operatively every 15 minutes X 2, every 30 minutes X 2, every hour X 2, than every four hours ( may have different guidelines for each clinical agency).
  • Monitor for complications associated with non-functioning liver ( bleeding, encephalopathy, etc).
  • Monitor for s/s of infection and peritonitis ( abdomen rigidity, pain, and distention).
  • Administer immunosuppressive medications as ordered.
  • Teach client about medication regimen, including when to take, how often, potential side-effects, reasons to seek additional medical attention.
  • Monitor for signs/ symptoms of complications.

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