Urinary Disorders Q 133

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The client is to undergo kidney transplantation with a living donor. Which of the following preoperative assessments is important?

  

    A. Urine output

    B. Signs of graft rejection

    C. Signs and symptoms of infection

    D. Client’s support system and understanding of lifestyle changes.

    

    

Correct Answer: D. Client’s support system and understanding of lifestyle changes.

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The client undergoing renal transplantation will need vigilant follow-up care and must adhere to the medical regimen. For many people, getting a kidney transplant can feel like getting another chance at life. There are many great things that come with getting a kidney transplant, like having more time in the day and more freedom. There are also many things the client should consider in the life after transplant that involve taking care of the new kidney.

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Option A: The client is most likely anuric or oliguric preoperatively but postoperatively will require close monitoring of urine output to make sure the transplanted kidney is functioning optimally. Those patients who were followed for 6 months post-transplant were observed to have a mean urine volume of 3.20 +/- 1.24 L at the end of this period. This trend showed that urine volume steadily decreased from 24 and 48 hours to 1 month after renal transplantation

Option B: Rejection can occur postoperatively. Though kidney transplants are often successful, there are some cases when they are not. It is possible that the body may refuse to accept the donated kidney shortly after it is placed in the body. It is also possible the new kidney may stop working overtime.

Option C: While the client will always need to be monitored for signs and symptoms of infection, it’s most important postoperatively due to the immunosuppressant therapy. One risk of a kidney transplant is that the body will reject (fight) the new kidney. This can happen if the body’s immune system realizes that the kidney is from someone else. To prevent this from happening, the client must take medicines to weaken the immune system. These medicines are called immunosuppressants, or anti-rejection medicines.

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