A nurse provides teaching to a patient who has undergone kidney ...

[leo leo]

A nurse provides teaching to a patient who has undergone kidney transplantation and will begin taking cyclosporine (Sandimmune), a glucocorticoid, and sirolimus (Rapamune).
 
  Which statement by the patient indicates understanding of the teaching?
  a. I should take sirolimus at the same time as the cyclosporine.
  b. I will need to have my blood sugar checked regularly.
  c. I will need to take an antibiotic to prevent lung infections.
  d. Taking this combination of drugs lowers my risk of kidney damage.

Question 2

A patient has undergone liver transplantation. The provider orders cyclosporine (Sandimmune), prednisone, and sirolimus (Rapamune). What will the nurse do?
 
  a. Question the order for sirolimus.
  b. Request an order for a serum glucose level.
  c. Request an order for a macrolide antibiotic.
  d. Suggest changing the cyclosporine to tacrolimus.

[angrybirds13579]

Answer to Question 1

ANS: C
Immunosuppressant drugs increase the risk of infections, especially the BK virus, which can cause renal damage, and other organisms that cause lung infections. Patients taking these drugs must take antibiotics for the first 12 months to help prevent infection. Sirolimus and cyclosporine should be taken 4 hours apart. Patients with diabetes may have trouble with glucose tolerance and require monitoring. Taking cyclosporine and sirolimus increases the risk of renal damage.

Answer to Question 2

ANS: A
Sirolimus is given to prevent rejection in renal transplantation; it has no proof of efficacy in patients with heart, lung, or liver transplants. A serum glucose level is not indicated; patients taking repaglinide for diabetes should be monitored closely while taking cyclosporine. Although antibiotic prophylaxis may be necessary, macrolide antibiotics increase the level of cyclosporine. Tacrolimus is more toxic than cyclosporine.

[leo leo]

TY

[angrybirds13579]

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