A patient who received a kidney transplant seven years ago is ...

[ssal]

A patient who received a kidney transplant seven years ago is seen for increasing blood pressure and proteinuria. The nurse realizes that this patient is demonstrating signs of what health problem?
 
  1. chronic rejection
  2. acute rejection
  3. renal artery stenosis
  4. pyelonephritis

Question 2

A patient with chronic kidney disease is trying to decide between hemodialysis and peritoneal dialysis. What should the nurse encourage the patient to consider as advantages of peritoneal dialysis?
 
  Select all that apply.
  1. minimal vascular complications
  2. liberal intake of fluids
  3. better self-management
  4. better metabolite elimination
  5. lower risk of infection

[thall411]

Answer to Question 1

Correct Answer: 1
Chronic rejection may develop months to years following transplant. The manifestations of azotemia, proteinuria and hypertension are those of progressive kidney disease. Acute rejection most commonly occurs in the weeks that immediately follow transplant. Renal artery stenosis manifests with a bruit over the surgical anastomosis site. Pyelonephritis manifests with abdominal discomfort and low-grade fever.

Answer to Question 2

Correct Answer: 1, 2, 3
Peritoneal dialysis has several advantages over hemodialysis. Heparinization and vascular complications associated with an arteriovenous (AV) fistula are avoided. The clearance of metabolic wastes is slower but more continuous. More liberal intake of fluid and nutrients is often allowed for the patient on continuous ambulatory peritoneal dialysis (CAPD). The patient on peritoneal dialysis is better able to self-manage the treatment regimen, which reduces feelings of helplessness. The major disadvantages of peritoneal dialysis include less effective metabolite elimination and risk for infection (peritonitis), serum triglyceride levels may increase, and the presence of an indwelling catheter may cause a body image disturbance.

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