The nurse is caring for a patient after recent renal ...

[mpobi80]

The nurse is caring for a patient after recent renal transplantation. The patient is taking sirolimus (Rapamune) to prevent transplant rejection. What other medications would the nurse expect the patient to be taking?
 
  a. Rifampin and ketoconazole
  b. Carbamazepine and phenobarbital
  c. Cyclosporine and glucocorticoids
  d. Amphotericin B and erythromycin

Question 2

A patient is started on immunosuppressant drugs after kidney transplantation and will be taking azathioprine (Imuran) as part of the drug regimen.
 
  The patient asks the nurse why it is necessary to have a specimen for a complete blood count drawn at the beginning of therapy and then periodically thereafter. The nurse explains that azathioprine can alter blood cells and tells the patient to report:
  a. alopecia.
  b. easy bruising.
  c. fatigue.
  d. gastrointestinal (GI) upset.

[ryansturges]

Answer to Question 1

ANS: C
Sirolimus should be used in conjunction with cyclosporine and glucocorticoids to reduce the risk of transplant rejection. Rifampin can reduce and ketoconazole can increase therapeutic levels of sirolimus and cyclosporine; therefore, they are not indicated for transplant patients. Carbamazepine and phenobarbital are not indicated, because they can reduce the therapeutic levels of sirolimus and cyclosporine. Amphotericin B and erythromycin are not indicated, because they can increase the therapeutic levels of sirolimus and cyclosporine.

Answer to Question 2

ANS: B
Azathioprine can cause bone marrow suppression, resulting in neutropenia and thrombocytopenia; therefore, a CBC must be evaluated at baseline and periodically thereafter. Patients who have low platelet counts bruise easily, so this symptom should be reported. Alopecia occurs with azathioprine, but is not a life-threatening side effect. Fatigue is not a common adverse effect. GI side effects occur but are not life threatening.

[mpobi80]

TYSM

[mjenn52]

Excellent