A nurse is evaluating a client who underwent a kidney transplant 2 weeks ago. Which of the following clinical manifestations should the nurse recognize as potential indication of organ rejection?

Temperature 36.1° C (97.0°F)

Weight loss

Hypertension

Insomnia

Answer and Explanation

The Correct Answer is C

A. Temperature 36.1° C (97.0°F): A low or normal temperature is not indicative of organ rejection. Fever (≥ 38°C / 100.4°F) is a more concerning sign and may suggest rejection or infection.

B. Weight loss: Rejection often leads to fluid retention, not weight loss. Clients may actually experience weight gain due to fluid overload.

C. Hypertension: Hypertension is a key indicator of acute kidney rejection due to inflammation and impaired kidney function, leading to fluid retention and increased blood pressure. Rejection can cause renal vascular resistance and reduced urine output, leading to fluid overload and elevated blood pressure.

D. Insomnia: Insomnia is not a direct symptom of rejection. It may be due to medications like corticosteroids (e.g., prednisone), anxiety, or post-transplant stress.

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Correct Answer is D

Explanation

A. Irritability is a common side effect of steroids but is not the most concerning.

B. Headaches can occur with steroid use, but they are not as urgent unless associated with severe symptoms.

C. Weight loss is not a common concern with steroids, as they usually cause weight gain.

D. High blood pressure is a serious side effect of steroid use and should be addressed promptly to avoid cardiovascular complications.

A. Weight gain B. Creatinine level of 1.0 (0.6-1.2 mg/dL) C. GFR of 100 mL/min (>90 ml/min) D. Weight loss

Correct Answer is D

Explanation

A. Weight gain is typically seen in the oliguric phase, not the diuresis phase. In the diuresis phase, the client is excreting excess fluid, leading to weight loss.

B. A creatinine level of 1.0 is within the normal range and would not be expected during the diuresis phase of acute kidney injury, when creatinine levels would still be elevated.

C. GFR of 100 mL/min is normal, but in acute kidney injury, the GFR would be decreased. A GFR above 90 mL/min would not be expected in the diuresis phase.

D. Weight loss is a key finding in the diuresis phase due to the loss of excess fluids as the kidneys begin to recover.

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A nurse is evaluating a client who underwent a kidney transplant 2 weeks ago. Which of the following clinical manifestations should the nurse recognize as potential indication of organ rejection?

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Naxlex Comprehensive Predictor Exams

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