A nurse is caring for a male client who has a new prescription for cyclosporine following a kidney transplant. Which of the following findings should the nurse identify as an adverse effect of this therapy?

Fasting blood glucose 65 mg/dL (70 to 110 mg/dL)

RBC count 6.3/μL (4.7 to 6.1/μL)

BUN 24 mg/dL (10 to 20 mg/dL)

Alkaline Phosphatase (ALP) 25 units/L (30 to 120 units/L)

Answer and Explanation

The Correct Answer is C

Rationale:
A. Fasting blood glucose 65 mg/dL (70 to 110 mg/dL): While slightly below the normal range, this mild hypoglycemia is not a typical adverse effect of cyclosporine. Cyclosporine is more commonly associated with nephrotoxicity, hypertension, and increased infection risk rather than altering glucose levels significantly.

B. RBC count 6.3/μL (4.7 to 6.1/μL): This value is slightly elevated but not clinically concerning and is not a known adverse effect of cyclosporine. The medication typically affects white blood cells and kidney function more than red cell production.

C. BUN 24 mg/dL (10 to 20 mg/dL): An elevated BUN level may indicate reduced kidney function, which is a common adverse effect of cyclosporine. This immunosuppressant is nephrotoxic and requires close monitoring of renal function through BUN and creatinine levels.

D. Alkaline Phosphatase (ALP) 25 units/L (30 to 120 units/L): This ALP level is slightly below normal but not typically associated with cyclosporine use. Cyclosporine does not usually cause significant changes in ALP unless there is liver involvement, which is less common than kidney-related complications.

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Correct Answer is D

Explanation

Rationale:
A. Hypotension: Circulatory overload typically causes hypertension rather than hypotension due to increased blood volume and pressure. Hypotension would be more consistent with a different transfusion reaction such as anaphylaxis or septic shock.

B. Flattened jugular veins: Jugular vein distention, not flattening, is a classic sign of circulatory overload. Distended neck veins indicate elevated central venous pressure from fluid excess.

C. Lethargy: While lethargy may occur with various conditions, it is not a specific or early sign of circulatory overload. More immediate symptoms include respiratory distress and cardiovascular changes.

D. Bounding pulse: A bounding pulse is a key sign of circulatory overload, reflecting increased stroke volume and elevated intravascular volume. It often occurs alongside hypertension, dyspnea, and jugular vein distention, especially in older adults with compromised cardiac function.

A. Close the pinch clamp on the CVC. B. Obtain a prescription for stat ABGs. C. Place the client in left Trendelenburg position. D. Check the tubing for placement of a locking adaptor.

Correct Answer is C

Explanation

Rationale:
A. Close the pinch clamp on the CVC: Clamping the catheter is important to stop further air entry, but placing the client in the proper position takes priority to trap the air and prevent it from reaching the pulmonary circulation.

B. Obtain a prescription for stat ABGs: ABGs may help assess respiratory compromise, but they are not the immediate action. This diagnostic step should follow emergency interventions that prevent further complications from an air embolism.

C. Place the client in left Trendelenburg position: This is the priority action because it helps trap any air in the right atrium and prevents it from entering the pulmonary arteries, reducing the risk of a fatal air embolism. Positioning the client correctly is a critical first step in managing suspected air embolism.

D. Check the tubing for placement of a locking adaptor: Verifying equipment setup is important for preventing future incidents, but it does not address the client’s current critical condition. Immediate positioning takes precedence.

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A nurse is caring for a male client who has a new prescription for cyclosporine following a kidney transplant. Which of the following findings should the nurse identify as an adverse effect of this therapy?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is assessing an older adult client who is receiving 2 units of packed RBCs. Which of the following manifestations should indicate to the nurse that the client is experiencing circulatory overload?

Correct Answer is D

Explanation

Correct Answer is C

Explanation

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