Kidney Transplant (10 Questions)

1. A 52-year-old client is 6 hours post-operative from a deceased donor kidney transplant. For the first 5 hours, their urinary output was consistently over 100 mL/hr. The nurse notes that in the last hour, the output has dropped to 20 mL. The client's blood pressure is 110/70 mmHg, and they report mild incisional pain.

Question:
What is the nurse's priority action? *
2. M. Jacques Tremblay, 45 years old, is in the Operating Room receiving a kidney transplant. The surgeon has just unclamped the blood vessels to reperfuse the new kidney. Within minutes, the new kidney turns blue, mottled, and flaccid instead of pink and firm. No urine is produced.

Medical Orders:
*Intra-operative monitoring.

Question:
What condition is occurring? *
3. Mme. Ginette Roy, 32 years old, received a living donor kidney transplant 2 weeks ago. She presents to the clinic for follow-up.

Assessment:
*Patient reports malaise and low-grade fever (37.9°C).
*The transplant site (iliac fossa) is tender to palpation.
*Weight gain: 2 kg in 3 days.
*Urine Output: Decreased (Oliguria).
*Blood Pressure: 160/95 mmHg.

Medical Orders:
*Serum Creatinine STAT.
*Kidney Ultrasound.

Question:
What do these clinical findings suggest? *
4. M. Pierre Gagnon, 55 years old, is preparing for discharge post-transplant. He is prescribed Tacrolimus (Prograf), Mycophenolate Mofetil (CellCept), and Prednisone.

Medical Orders:
*Discharge teaching.

Question:
M. Gagnon asks, "Can I stop these pills once my new kidney is working perfectly and I feel healthy?" What is the nurse’s priority response? *
5. Mme. Claire Bouchard, 60 years old, received a deceased donor kidney 24 hours ago.

Assessment:
*Urine Output: < 20 mL/hr (Oliguria) despite adequate fluid intake.
*Creatinine: Remains elevated (no decrease since surgery).
*Ultrasound: Normal blood flow to the kidney.

Medical Orders:
*Continue Dialysis PRN.
*Monitor daily labs.

Question:
What is the most likely cause of the delayed graft function? *
6. M. Robert Fortin, 40 years old, is being discharged on high-dose immunosuppressants. He works as a kindergarten teacher.

Medical Orders:
*Discharge home.
*Return to work in 3 months.

Question:
What specific infection control advice is most relevant for his lifestyle? *
7. Mme. Sophie Lemieux, 50 years old, complains of increased appetite and weight gain since starting Prednisone.

Medical Orders:
*Dietary Consult.

Question:
Which dietary modification helps manage the side effects of long-term corticosteroids? *
8. Mme. Valérie Turcotte, 29 years old, calls the transplant coordinator. She has a headache and asks what she can take.

Medical Orders:
*Medication teaching.

Question:
What is the safest recommendation? *
9. M. Michel Desjardins, 65 years old, is 4 hours post-transplant.

Assessment:
*Urine Output: 500 – 800 mL/hr.
*BP: 110/70.
*CVP: 4 mmHg.

Medical Orders:
*IV fluid replacement 1:1 with urine output.
*Monitor electrolytes.

Question:
What is the nurse’s priority concern with this high output? *
10. An 18‑year‑old man presents to a transplant clinic requesting to donate one of his kidneys to his girlfriend. He states that he understands the surgery is irreversible and says he has thought carefully about the decision. His parents strongly oppose the donation and insist he is too young to make such a permanent choice. The patient acknowledges his parents’ concerns but reiterates that he is legally an adult and wants to proceed with the donation.

Question
What is the nurse’s priority in supporting ethical decision‑making in this situation? *