A client is receiving tacrolimus (Prograf) to prevent organ ...

[yoooooman]

A client is receiving tacrolimus (Prograf) to prevent organ rejection. Which of the following is a nursing considerations associated with this medication?
 
  1. Give with cyclosporine (Sandimmune).
  2. Assess for hypoglycemia.
  3. Give with grapefruit juice.
  4. Assess platelet count for thrombocytopenia.

Question 2

A client who has undergone renal transplant is receiving ongoing therapy with cyclosporine (Sandimmune). The nurse would be sure to immediately report the results of periodic laboratory results that indicate which of the following?
 
  1. Decreased creatinine level
  2. Decreased hemoglobin level
  3. Elevated blood urea nitrogen (BUN) level
  4. Decreased white blood cell (WBC) count

[akudia]

Answer to Question 1

4

Rationale: Tacrolimus (Prograf) is an alternative to cyclosporine for prevention of organ rejection in clients receiving an organ transplant. It should never be given with cyclosporine because of its toxic effects on the kidney. This medication will cause hyperglycemia (not hypoglycemia). Grapefruit juice can increase tacrolimus levels so it should be avoided to prevent toxicity. Tacrolimus suppresses the bone marrow, so it can cause anemia, thrombocytopenia, and neutropenia.

Answer to Question 2

3

Rationale: The use of cyclosporine (Sandimmune) can cause nephrotoxicity. This complication is detected by assessing for elevated levels of BUN and serum creatinine. Decreased hemoglobin level and decreased white blood cell (WBC) count are incorrect because cyclosporine does not depress the bone marrow.

[yoooooman]

Thanks for the timely response, appreciate it

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TYSM