Complex: GI, Renal, Hepatic, Transplant Flashcards
Transplant: Describe nursing priorities for patients undergoing a transplant
Patient safety is always the nursing priority and in the context of transplant, patients are immunocompromised. Actions should be taken to minimize infection risk to the patient
Transplant: Explain the nurses’ role during end-of-life and organ donation
The nurse should understand that it is out of their scope of practice to make recommendations, use coercion, or make decisions regarding the donation process. It is in their scope of practice to serve as a witness to things such as informed consent.
Renal: Describe the assessment for an AV fistula
The nurse should always assess for a thrill and bruit and should remind the care team of the location of the fistula to prevent risk to the site.
Describe the least invasive method of promoting easier work of breathing
Raise the head of the bed
GI: Describe the manifestations that may occur from electrolyte imbalance in the presence of pancreatitis
Pancreatitis may cause hypocalcemia and muscle spasms may occur
Hep: Describe why a patient in liver failure may demonstrate change in mentation and involuntary hand movement
A patient with liver failure is not able to control ammonia levels which can lead to hepatic encephalopathy
Hep: Explain why a patient with liver failure may demonstrate change in mentation and involuntary hand movement.
Liver failure prevents the excretion of ammonia which may lead to hepatic encephalopathy
Transplant: Identify early signs of rejection in the presence of a kidney transplant
Abnormal BUN & Creatinine
Change in vital signs (Temp & BP)
Decreased urine output
Lethargy
Pain not related to incision
Transplant: Explain the rationale for using a single set of vital sign assessment equipment in the room of a patient who has undergone a stem cell transplant
Patients receiving stem cell transplant receive high doses of chemotherapy to suppress the immune system so that the stem cells can be transplanted. This makes them highly susceptible to infection, therefore, a dedicated set of equipment should be used for these patients.
Transplant: Describe why substance abuse might be a contraindication to a patient needing a kidney transplant
The systemic effects of substances like alcohol and tobacco can cause damage to the kidneys
Transplant: Discuss the teaching that transplant patients should receive regarding the handling of food and food preparation
The nurse should stress the importance of safe food-handling practices to avoid foodborne illness due to the immunosuppressant medications the client is taking.
Donation: Organ donation is a sensitive subject for some. Describe the role of the nurse when helping families who are faced with the decision of organ donation
Federal law requires facilities to have policies and procedures in place about making a request for organ and tissue donation at the time of death. The request is made by an employee, often a social worker, who has advanced training and can request the donations in a caring, sensitive manner. The role of the nurse is to provide emotional support to the family. Family members should consider the deceased person’s wishes when making their decision.
Donation: Discuss the nurses role in the process of organ donation
Once a patient has a confirmation of brain death, the nurse should partner with the organ donation service and allow them to discuss organ donation with the family. At the time that the family decides to donate organs or tissues, the nurse is able to sign as a witness to the consent. The organ donation service proceeds with the evaluation of the donor. The management of the donor may require the nurse to maintain organ perfusion until the time of organ harvest.
