The nurse is teaching the client taking cyclosporine after renal transplantation about key medication information. The nurse tells the client to be especially alert for?

1. A

   Signs of infection

2. B

   Hypotension

3. C

   GI disturbances

4. D

   Hair loss

Appeared in: AIIMS Bhatinda NO - 2019

Explanation

• Cyclosporine is a calcineurin inhibitor that suppresses the immune system to prevent the body from rejecting a transplanted organ.
• This immunosuppression is the drug's intended therapeutic effect, but it also leaves the patient highly vulnerable to bacterial, viral, and fungal infections.
• Infections are a leading cause of morbidity and mortality in transplant recipients, making it the most critical risk for the patient to monitor.
• Early signs of infection like fever, sore throat, or chills must be reported immediately to allow for prompt treatment and prevent sepsis.

Why Other Options Were Wrong

• Option B: Cyclosporine is known to cause hypertension (high blood pressure) in a significant number of patients, not hypotension (low blood pressure).
• Option C: While gastrointestinal disturbances like nausea and diarrhea can occur with cyclosporine, they are generally not considered the most life-threatening or urgent side effect compared to the risk of a severe infection.
• Option D: Cyclosporine is more commonly associated with hirsutism, which is excessive hair growth, particularly on the face and body. Hair loss (alopecia) is not a typical side effect.

Related Visual

Clinical Relevance

• Nursing practice connection: Safe nursing care depends on performing Patient education regarding adverse effects of immunosuppressant therapy in the correct sequence, documenting the action clearly, and monitoring for the expected response.
• Patient education is a cornerstone of nursing care for transplant recipients. Empowering the patient to be an active participant in monitoring for complications is crucial for long-term graft survival and patient safety.
• Nurses must emphasize that common symptoms like a mild fever or sore throat, which might be ignored by a healthy person, can signify a serious infection in an immunosuppressed patient and require immediate medical attention.
• What if? If the patient reported a persistent headache and blurred vision, the nurse's priority concern would shift to assessing for hypertension, another major adverse effect of cyclosporine that requires management to prevent cardiovascular and renal damage.

How to Approach the Question

• First, identify the drug in the question: cyclosporine.
• Recall the drug's class and primary mechanism of action. Cyclosporine is an immunosuppressant.
• Think about the main consequence of suppressing the immune system. The body's ability to fight off pathogens is significantly reduced.
• Therefore, the greatest and most immediate risk to the patient is infection.
• Evaluate the options based on this primary risk. 'Signs of infection' directly relates to the drug's main effect.
• Quickly rule out the other options by recalling other key side effects: cyclosporine causes hypertension (not hypotension) and hirsutism (not hair loss).

Concept Tested & Keywords

• Concept Tested: Patient education regarding adverse effects of immunosuppressant therapy.
• Stem keywords: cyclosporine, renal transplantation, medication information, teaching
• Lead-in keywords: especially alert for
• Clinical cues: The patient is post-renal transplant, indicating a compromised immune state even before medication.
• Clinical cues: The medication is cyclosporine, a potent immunosuppressant.

Question ID

QZf2I0BiB7eSShvJ6SU4sl

Copy ID

Reference Book

E6 Pharmacology Nursing Lilley 11e Part 3 pp. 143-145, 141-143