This topic contains a solution. Click here to go to the answer
« previous next »

Author Question: A patient is taking cyclosporine (Sandimmune) and prednisone to prevent organ rejection after right ... (Read 51 times)

oliviahorn72

  • Hero Member
  • *****
  • Posts: 579
on: Jul 23, 2018
A patient is taking cyclosporine (Sandimmune) and prednisone to prevent organ rejection after right renal transplantation. The patient is febrile and complains of right-sided flank pain.
 
  The nurse reviews the patient's chart and finds that the patient's BUN and serum creatinine are elevated. The cyclosporine trough is 150 ng/mL. What will the nurse do?
  a. Be concerned that the left kidney is failing.
  b. Expect the provider to order intravenous methylprednisolone.
  c. Request an order for a urine culture.
  d. Suspect nephrotoxicity secondary to an elevated cyclosporine level.

Question 2

A patient with a history of lung transplantation is admitted for treatment for a respiratory infection. The patient has been taking cyclosporine (Sandimmune), prednisone, and azathioprine (Imuran) for 8 months.
 
  The provider has ordered azithromycin (Zithromax) to treat the infection and acetaminophen (Tylenol) as needed for fever. The nurse will contact the provider to:
  a. ask whether a different antibiotic can be used.
  b. ask that the prednisone be discontinued until the infection clears.
  c. suggest increasing the dose of cyclosporine.
  d. suggest using ibuprofen instead of acetaminophen.


Related Topics

Need homework help now?

Ask unlimited questions for free

Ask a Question
Marked as best answer by a Subject Expert

matt95

  • Sr. Member
  • ****
  • Posts: 317
Reply #1 on: Jul 23, 2018
Answer to Question 1

ANS: B
The patient is showing signs of acute organ rejection, which include pain at the graft site, fever, and elevated BUN and creatinine; therefore, intravenous methylprednisolone is indicated. Because the patient is having pain on the right side, along with fever and elevated renal function test results, there is no reason to suspect that the left kidney is failing or that an infection is present. The cyclosporine level is within normal limits.

Answer to Question 2

ANS: A
Macrolide antibiotics, such as azithromycin, can inhibit cyclosporine metabolism, leading to increased levels of the drug. This patient needs either a reduced dose of cyclosporine or a different antibiotic. There is no indication for discontinuing the prednisone during treatment. The dose of cyclosporine would need to be reduced, because azithromycin leads to increased drug levels. There is no contraindication to using acetaminophen.


oliviahorn72

  • Member
  • Posts: 579
Reply 2 on: Jul 23, 2018
Excellent

  • Member
  • Posts:
Reply 3 on: Yesterday
Gracias!

« previous next »
 

Did you know?

Malaria mortality rates are falling. Increased malaria prevention and control measures have greatly improved these rates. Since 2000, malaria mortality rates have fallen globally by 60% among all age groups, and by 65% among children under age 5.

Did you know?

About 3.2 billion people, nearly half the world population, are at risk for malaria. In 2015, there are about 214 million malaria cases and an estimated 438,000 malaria deaths.

Did you know?

Walt Disney helped combat malaria by making an animated film in 1943 called The Winged Scourge. This short film starred the seven dwarfs and taught children that mosquitos transmit malaria, which is a very bad disease. It advocated the killing of mosquitos to stop the disease.

Did you know?

Pope Sylvester II tried to introduce Arabic numbers into Europe between the years 999 and 1003, but their use did not catch on for a few more centuries, and Roman numerals continued to be the primary number system.

Did you know?

According to the National Institute of Environmental Health Sciences, lung disease is the third leading killer in the United States, responsible for one in seven deaths. It is the leading cause of death among infants under the age of one year.

Taking a Patient’s Axillary Temperature Taking a Patient’s Axillary Temperature
A pharmacist can explain to a patient why medication may look different and ensure the correct ... A pharmacist can explain to a patient why medication may look different and ensure the correct ...
Apply direct pressure to the patient’s wound. Apply direct pressure to the patient’s wound.
Foley catheter with balloon in the bladder of a male patient. Foley catheter with balloon in the bladder of a male patient.
Areas of sclerosis (see arrows) in the white matter of a patient with MS. Areas of sclerosis (see arrows) in the white matter of a patient with MS.
Keeping a Salad Dressing Blended To prevent the fat from separating out in a salad dressing Keeping a Salad Dressing Blended To prevent the fat from separating out in a salad dressing
Video: Immune responses Animation

For a complete list of videos, visit our video library