The nurse is caring for a patient 22 hours after undergoing kidney transplantation. The patient develops hyperacute rejection of the transplanted kidney. What intervention will the nurse anticipate for this patient at this time?

Removal of the transplanted kidney.

An increase in the dose of cyclosporine therapy.

A new kidney transplant from a living donor.

Administration of methylprednisolone sodium succinate.

Answer and Explanation

The Correct Answer is A

Choice A reason: Removal of the transplanted kidney is the definitive intervention for hyperacute rejection. Hyperacute rejection occurs within minutes to hours after transplantation due to pre-formed antibodies against the donor organ. This form of rejection is irreversible and requires immediate removal of the transplanted kidney to prevent further complications and damage to the recipient's health.

Choice B reason: An increase in the dose of cyclosporine therapy is not effective in hyperacute rejection. Cyclosporine is an immunosuppressive medication used to prevent rejection, but in cases of hyperacute rejection, the rapid and severe immune response cannot be controlled by increasing the dose. The affected kidney must be removed.

Choice C reason: A new kidney transplant from a living donor is not an immediate intervention for hyperacute rejection. Before considering another transplant, it is essential to identify and address the underlying cause of hyperacute rejection and ensure that the recipient's immune system is adequately managed to prevent recurrence.

Choice D reason: Administration of methylprednisolone sodium succinate is typically used to manage acute rejection episodes but is not effective for hyperacute rejection. The rapid onset and severity of hyperacute rejection necessitate the removal of the transplanted organ rather than relying on immunosuppressive medications.

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Correct Answer is B

Explanation

Choice A reason: Normal blood pressure and deep respirations do not necessarily indicate that hyperosmolar hyperglycemic syndrome is resolving. Deep respirations, also known as Kussmaul respirations, can occur in response to severe hyperglycemia.

Choice B reason: Increased alertness and a normal heart rhythm suggest that the patient's neurological status and cardiovascular system are stabilizing, which are positive indicators that the treatment is effective in managing hyperosmolar hyperglycemic syndrome.

Choice C reason: High urine specific gravity and normal temperature do not directly indicate the effectiveness of treatment for hyperosmolar hyperglycemic syndrome. High urine specific gravity can result from dehydration.

Choice D reason: A blood glucose level of 250 mg/dL with disorientation still indicates poorly controlled hyperglycemia and ongoing metabolic disturbance, which means the treatment is not yet effective.

A. Arterial pH less than 7.3 B. Altered mental status C. Presence of ketones in urine D. Serum bicarbonate less than 15 mEq/L

Correct Answer is B

Explanation

Choice A reason: An arterial pH less than 7.3 indicates acidosis, which is common in diabetic ketoacidosis but not typical in hyperglycemic hyperosmolar syndrome. Patients with hyperglycemic hyperosmolar syndrome typically have a near-normal pH.

Choice B reason: Altered mental status is a significant clinical manifestation in hyperglycemic hyperosmolar syndrome due to severe hyperglycemia and the hyperosmolar state, which can lead to dehydration and impaired brain function.

Choice C reason: The presence of ketones in urine is more commonly associated with diabetic ketoacidosis rather than hyperglycemic hyperosmolar syndrome. The absence of significant ketonemia differentiates hyperglycemic hyperosmolar syndrome from diabetic ketoacidosis.

Choice D reason: Serum bicarbonate less than 15 mEq/L is indicative of metabolic acidosis, typically seen in diabetic ketoacidosis rather than hyperglycemic hyperosmolar syndrome, where bicarbonate levels are usually normal or slightly decreased.

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The nurse is caring for a patient 22 hours after undergoing kidney transplantation. The patient develops hyperacute rejection of the transplanted kidney. What intervention will the nurse anticipate for this patient at this time?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Explanation

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Explanation

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