A nurse reviews these laboratory values of a client who returned ...

[fnuegbu]

A nurse reviews these laboratory values of a client who returned from kidney transplantation 12 hours ago:
 
  Sodium
  136 mEq/L
  Potassium
  5 mEq/L
  Blood urea nitrogen (BUN)
  44 mg/dL
  Serum creatinine
  2.5 mg/dL
  What initial intervention would the nurse anticipate?
  a.
  Start hemodialysis immediately.
  b.
  Discuss the need for peritoneal dialysis.
  c.
  Increase the dose of immunosuppression.
  d.
  Return the client to surgery for exploration.

Question 2

A client is recovering from a kidney transplant. The client's urine output was 1500 mL over the last 12-hour period since transplantation. What is the priority assessment by the nurse?
 
  a. Checking skin turgor
  b. Taking blood pressure
  c. Assessing lung sounds
  d. Weighing the client

[Brummell1998]

Answer to Question 1

ANS: C
The client may need a higher dose of immunosuppressive medication as evidenced by the elevated BUN and serum creatinine levels. This increased dose may reverse the possible acute rejection of the transplanted kidney. The client does not need hemodialysis, peritoneal dialysis, or further surgery at this point.

Answer to Question 2

ANS: B
By taking blood pressure, the nurse is assessing for hypotension that could compromise perfusion to the new kidney. The nurse then should notify the provider immediately. Skin turgor, lung sounds, and weight could give information about the fluid status of the client, but they are not the priority assessment.