C HAPTER 36: O RGAN D ONATION AND
T RANSPLANTATION
Urden: Critical Care Nursing, 9th Edition
MULTIPLE CHOICE
1. After a pancreatic transplant with bladder exocrine drainage, the nurse
would anticipate which order?
a. Continuous bladder irrigation
b. Intermittent insulin injections
c. Removal of the nasogastric tube as soon as the patient is alert
d. Dail y hematocrit and h emoglobin levels
ANS: A
An increased potential for urinary catheter occlusion exists for
pancreas recipients who have undergone a urinary diversion procedure.
The exocrine pancreatic enz ymes make the urine more viscous, and
they irritate the anastomosis site on the bladder, causing an increased
risk of bleeding. Continuous bladder irrigation may be necessary to
keep the catheter patent.
DIF: Cognitive Level: Appl ying REF: p. 899 OBJ:
Nursing Process Step: Assessment TOP: Transplantation
MSC: NC LEX: Physiologic Integrit y
,2. The nurse is caring for a patient with a pancreas transplant. Which
statement made by the patient indicates the need for further teaching?
a. “I no longer need to monitor m y blood glucose levels.”
b. “I will need to have periodic pancreas biopsies.”
c. “I may feel the urge to urinate frequentl y.”
d. “I will give urine samples to monitor for rejection.”
ANS: A
Patients with functional pancreas grafts continue to need glucose
monitoring at home but often forget to continue this practice after the y
no longer require insulin. Continued monitoring with frequent clinic
visits is required for several months after pancreas transplantation.
DIF: Cognitive Level: Appl ying REF: p. 900 OBJ:
Nursing Process Step: Evaluation TOP: Transplantation
MSC: NC LEX: Health Promotion and Maintenance
3. Which statement made by a patient who has received an organ transplant
indicates that the teaching was effective?
a. “I will finall y be able to eat a regular diet.”
b. “I will establish a routine for checking any skin chang es.”
c. “I will check m y blood pressure regularl y to make sure it’s not too
high.”
d. “After m y drug regimen is established, I won’t have to worry about
rejection.”
ANS: B
, Immunosuppressed patients are at greater risk for developing skin
cancer. After transplantation, such a patient needs to monitor for
hypotension and eat a diet that is low in sodium, fat, and cholesterol.
DIF: Cognitive Level: Appl ying REF: p. 885 OBJ:
Nursing Process Step: Evaluation TOP: Transplantation
MSC: NC LEX: Health Promotion an d Maintenance
4. A nurse is caring for a patient who is receiving sirolimus. The nurse
knows to monitor the patient for what side effect?
a. Bleeding
b. Diarrhea
c. Rigors
d. Hypotension
ANS: A
Other primary side effects of this medication include hyperlipidemia
and m yelosuppression. Most of the m yelosuppressive effect is directed
at platelets, and severe thrombocytopenia can result, making it
necessary to discontinue the medication.
DIF: Cognitive Level: Appl ying REF: p. 875 | p. 876 | Table
36-6 OBJ: Nursing Process Step: Assessment TOP:
Transplantation MSC: NC LEX: Physiologic Integrit y
5. A patient who has received a transplant is being taught about
cyclosporine. Which statement made by the patient would indicate the
teaching was effective?
T RANSPLANTATION
Urden: Critical Care Nursing, 9th Edition
MULTIPLE CHOICE
1. After a pancreatic transplant with bladder exocrine drainage, the nurse
would anticipate which order?
a. Continuous bladder irrigation
b. Intermittent insulin injections
c. Removal of the nasogastric tube as soon as the patient is alert
d. Dail y hematocrit and h emoglobin levels
ANS: A
An increased potential for urinary catheter occlusion exists for
pancreas recipients who have undergone a urinary diversion procedure.
The exocrine pancreatic enz ymes make the urine more viscous, and
they irritate the anastomosis site on the bladder, causing an increased
risk of bleeding. Continuous bladder irrigation may be necessary to
keep the catheter patent.
DIF: Cognitive Level: Appl ying REF: p. 899 OBJ:
Nursing Process Step: Assessment TOP: Transplantation
MSC: NC LEX: Physiologic Integrit y
,2. The nurse is caring for a patient with a pancreas transplant. Which
statement made by the patient indicates the need for further teaching?
a. “I no longer need to monitor m y blood glucose levels.”
b. “I will need to have periodic pancreas biopsies.”
c. “I may feel the urge to urinate frequentl y.”
d. “I will give urine samples to monitor for rejection.”
ANS: A
Patients with functional pancreas grafts continue to need glucose
monitoring at home but often forget to continue this practice after the y
no longer require insulin. Continued monitoring with frequent clinic
visits is required for several months after pancreas transplantation.
DIF: Cognitive Level: Appl ying REF: p. 900 OBJ:
Nursing Process Step: Evaluation TOP: Transplantation
MSC: NC LEX: Health Promotion and Maintenance
3. Which statement made by a patient who has received an organ transplant
indicates that the teaching was effective?
a. “I will finall y be able to eat a regular diet.”
b. “I will establish a routine for checking any skin chang es.”
c. “I will check m y blood pressure regularl y to make sure it’s not too
high.”
d. “After m y drug regimen is established, I won’t have to worry about
rejection.”
ANS: B
, Immunosuppressed patients are at greater risk for developing skin
cancer. After transplantation, such a patient needs to monitor for
hypotension and eat a diet that is low in sodium, fat, and cholesterol.
DIF: Cognitive Level: Appl ying REF: p. 885 OBJ:
Nursing Process Step: Evaluation TOP: Transplantation
MSC: NC LEX: Health Promotion an d Maintenance
4. A nurse is caring for a patient who is receiving sirolimus. The nurse
knows to monitor the patient for what side effect?
a. Bleeding
b. Diarrhea
c. Rigors
d. Hypotension
ANS: A
Other primary side effects of this medication include hyperlipidemia
and m yelosuppression. Most of the m yelosuppressive effect is directed
at platelets, and severe thrombocytopenia can result, making it
necessary to discontinue the medication.
DIF: Cognitive Level: Appl ying REF: p. 875 | p. 876 | Table
36-6 OBJ: Nursing Process Step: Assessment TOP:
Transplantation MSC: NC LEX: Physiologic Integrit y
5. A patient who has received a transplant is being taught about
cyclosporine. Which statement made by the patient would indicate the
teaching was effective?
