Author Question: A patient with a liver transplant has been receiving cyclosporine (Sandimmune) for 6 months. The ... (Read 45 times)

neverstopbelieb · **on:** Jul 23, 2018

A patient with a liver transplant has been receiving cyclosporine (Sandimmune) for 6 months. The nurse reviews this patient's laboratory results and notes a sharp increase in the blood urea nitrogen (BUN) and serum creatinine.

Vital signs are normal, and the patient reports no discomfort. What does the nurse suspect?
a. Hepatotoxicity
b. Infection
c. Organ rejection
d. Nephrotoxicity

Question 2

The parent of a child receiving the polio vaccine wants to know why the oral polio vaccine (OPV) is not given. The nurse will explain to this parent that the oral preparation:

a. can cause paralytic poliomyelitis.
b. contains antigens that increase allergic reactions.
c. is less effective than the IPV.
d. is more expensive to administer.

yifu223 · **Reply #1 on:** Jul 23, 2018

Answer to Question 1

ANS: D
An elevation of BUN and serum creatinine is an indication of nephrotoxicity, which occurs in 75 of patients taking cyclosporine. Hepatotoxicity would cause elevations in liver enzymes, not the BUN and creatinine. Infection would be associated with fever. Organ rejection of a renal transplant would cause elevation in the BUN and creatinine but also would cause tenderness at the graft site and fever.

Answer to Question 2

ANS: A
The OPV is composed of live virus and has the potential to cause paralytic poliomyelitis; therefore, it is no longer given. The oral form is no more antigenic than the IPV, and the latter is just as effective. The oral form is not more expensive.