A nurse teaches a client recovering from a heart transplant who ...

[cdr_15]

A nurse teaches a client recovering from a heart transplant who is prescribed cyclosporine (Sandimmune). Which statement should the nurse include in this client's discharge teaching?
 
  a. Use a soft-bristled toothbrush and avoid flossing.
  b. Avoid large crowds and people who are sick.
  c. Change positions slowly to avoid hypotension.
  d. Check your heart rate before taking the medication.

Question 2

A nurse cares for a client with end-stage heart failure who is awaiting a transplant. The client appears depressed and states, I know a transplant is my last chance, but I don't want to become a vegetable. How should the nurse respond?
 
  a. Would you like to speak with a priest or chaplain?
  b. I will arrange for a psychiatrist to speak with you.
  c. Do you want to come off the transplant list?
  d. Would you like information about advance directives?

[BAOCHAU2803]

Answer to Question 1

ANS: B
These agents cause immune suppression, leaving the client more vulnerable to infection. The medication does not place the client at risk for bleeding, orthostatic hypotension, or a change in heart rate.

Answer to Question 2

ANS: D
The client is verbalizing a real concern or fear about negative outcomes of the surgery. This anxiety itself can have a negative effect on the outcome of the surgery because of sympathetic stimulation. The best action is to allow the client to verbalize the concern and work toward a positive outcome without making the client feel as though he or she is crazy. The client needs to feel that he or she has some control over the future. The nurse personally provides care to address the client's concerns instead of pushing the client's issues off on a chaplain or psychiatrist. The nurse should not jump to conclusions and suggest taking the client off the transplant list, which is the best treatment option.