الخميس، 21 يونيو 2018

7-Kidney Transplant

About
Diseased or impaired kidney surgically removed and replaced with a donor kidney.

Assess
Urine output hourly, bloody initially, BUN, Creatinine, Electrolytes, Incision, VS, fluid volume status

Complications
Rejection- may need to increase immunosuppressant therapies; tubular necrosis- may need dialysis for some time; thrombosis- immediate surgery to save graft; renal artery stenosis- surgical repair or nephrectomy; infections

Diagnosis
Ineffective protection related to immunosuppressant therapies

Goals
  • The client will identify the types, rationale for, and side effects of prescribed immunosuppressive therapies.
  • The client will understand pre-, intra-, and post-operative instructions.
  • The client will be able to eliminate sufficient quantities of urine.


Interventions
  • Monitor for s/s of rejection.
  • Monitor urine output, including color, quantity, clarity, and daily urinalysis.
  • 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 htn, pulmonary edema, arrhythmias every two hours minimally.
  • Monitor fluid balance, including frequent auscultation of lung sounds for signs of pulmonary edema.
  • Provide catheter care.
  • 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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