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Kidney Transplant

Renal 2 Exam

People who DO NOT qualify for kidney transplant CA, TB, Osteomyelitis, heart/lung/liver disease, High risk if have CV disorder or DM (although DM may have done)
Preop assessment includes Support of recipient and understanding of life challenges
What education would be provided Lifelong immunosupressants, stop smoking, maintain BP, control BG
What donors make up 80% of transplants? Cadaver
Live donors need to be _____ match and _______ compatible tissue, blood type
Best donor is twin or sibling
Donor will be in hospital ______ days 3-5
Donor should do no heavy labor/lifting for _____ months 1-2
Donor may return to work after _____ weeks 6-8
Recipients will be hospitalized for ____days 5-7
Recipient will require _______ doctor visits. weekly
Anti-rejection/immunosuppressants must be taken________ for life
New kidney is placed behind _________ for protection and attached to _______ artery and vein iliac crest, iliac
S/E transplant meds include wt gain, increased sweating, acne, puffy face, swollen abd, hand tremors, inc in amount of hair
Post-op ICU care Careful fluid replacement, may be on dialysis until kidney starts to fx (24h), hourly outputs, Daily UA, daily wts, monitor F&E, s/s infection
Rejection can occur __________ after transplant few days to months
50% of rejection occurs within first _____ months 3
_____% of rejections can be reversed. What meds are given? 90-95; Prograft, Cellcept, Imuran, Cyclosporine
Hyperacute rejection occurs with in _____ of Sx 48h
What are s/s of hyperacute rejection? Fever, HTN, pain at transplant site
What will happen to kidney of hyperacute rejection Removal
Acute rejection can occur ______week to ____ years after sx 1 week, 2 years
S/S acute rejection oliguria, anuria, low grade T, tenderness at sx site, HTN, lethargy, azotemia, fl retention, Inc BUN creat
Chronic rejection can happen over ____ to ____ after sx months to years
What are main sym of chronic rejection? How is it treated? Azotemia, fl retention, e-lyte imbalance. Tx with immunosuppressants, dialysis
What are complication of surgery for transplant? Infection, bleeding, thrombus, CA d/t immuno. drugs
What are some pros of transplant? Improved quality of life, most similar to original kidney function, no more dialysis, no restricted diet, normal schedule, lasts up to 25 years
What are some cons of transplant? Stress of waiting for match, risk of major surgery, risk of rejection, large number of meds (not carried at hospital. pt must bring. Expensive), decreased resist to illness/infection, gain approx 20 lb post transplant d/t fluid retention
Diet for transplant Balanced, nutritional, restrict Na
Created by: mreedy