The nurse has admitted a client to the clinical nursing unit ...

[JMatthes]

The nurse has admitted a client to the clinical nursing unit following right-sided mastectomy. The nurse plans to place the right-sided arm in which of the following positions?
 
  1. Level with the right-sided atrium
  2. Elevated above shoulder level
  3. Elevated on one or two pillows
  4. Dependent to the right-sided atrium

Question 2

Cyclosporine (Sandimmune) is prescribed for the client following allogenic kidney transplantation. The nurse provides instructions to the client regarding the medication and tells the client that:
 
  1. There are no known adverse effects of the medication.
  2. The medication will need to be taken for a period of 6 months.
  3. Blood levels of the medication will need to be measured periodically.
  4. The medication is administered by the intravenous (IV) route on a monthly basis.

[missalyssa26]

Answer to Question 1

3

Rationale: The client's operative arm should be positioned so that it is elevated on one or two pillows and does not exceed shoulder elevation. This promotes optimal drainage from the limb, without impairing the circulation to the arm. If the arm is positioned flat (level with the right-sided atrium) or dependent (dependent to the right-sided atrium), this could increase the edema in the arm, which is contraindicated because of lymphatic disruption caused by surgery.

Answer to Question 2

3

Rationale: To avoid toxicity from high medication levels and to avoid organ rejection from low medication levels, blood levels of cyclosporine should be measured periodically. In the organ transplant client, an immunosuppressant will need to be taken for life. Oral administration is the route of choice; IV administration is reserved for clients who cannot take the medication orally. The most serious adverse effects are nephrotoxicity and infection.

[JMatthes]

Thank you!

[missalyssa26]

Always glad to help...