CORE Flashcards
Who r the only ppl that call core
Nurses
Who isn’t eligible for organ donation
Ppl who already died
What are transplantable organs
Heart Liver Pancreas Lungs Kidneys Small bowel
CMO
Comfort measures only
If the order exists, before it is implemented CORE must be called
HLA
Human leukocyte antigen
Mist match to be suitable for organ donation
Describe the hyperacute rejection
Involves the humoral response
It is destructive and immediate it occurs in minutes to hours
It always results in graft destruction
What is early accelerated rejection
It involves the humoral response
It occurs within hours to days of transplant
Not reversible
What is acute rejection
It is usually T cell mediated
It occurs days to months after transplant
It is reversible
What is chronic rejection
Usually involves the humoral response
Usually occurs over a year
It is not reversible, will lead to allograft loss
Most difficult to dx
Antimetabolites
Immuran
Cellcept
( used with calcineurin inhibitor)
What are side effects of anti metabolites
Bone marrow suppression
Rash
Alopecia
GI effects with cellcept
Name calcineurin inhibitors
Cyclosporine
Sirolimus
Tacrolimua
What are side effects of calcineurin inhibitors
Nephro and hepatotoxic, neurotoxic
Hyperglycemia
Name corticosteroids
Prednisone
Methylprednisolone
Dexamethosone
What are side effects of corticosteroids
Cushing syndrome Hyperglycemia GI bleed HTN OSTEOPOROSIS
What is brain death
Brain death is determined by neurological criteria
What is cardiac death
Cardiac death is defined as ASYSTOLE
What is the general criteria for tissue donation
No limit Tissue removal within 24 Hrs of death No Hx of extracranial malignancies No Hx do autoimmune disease No Hx of transmissible bacterial, viral, fungal diseases or infections No Hx of bacteremia or viremia
Hyperacute rejection
Most destructive
Immediate in minutes to hours
Always results in graft destruction
Humoral response
Early accelerated rejection
NOT REVERSIBLE
occurs within hours to days of transplant
Acute rejection
Usually T cell mediated
Occurs days to months after transplant
REVERSIBLE
Chronic rejection
Usually humoral response Insidious Usually occurs over a year NOT REVERSIBLE, LEADS TO ALLOGRAFT LOSS MOST DIFFICULY TO DIAGNOSE
Give an example of a sign of a liver transplant rejection
Elevated LFTs
Give an example of a sign of a small bowel rejection
Watery, bloody diarrhea
Give an example of a sign of kidney rejection
Elevated bun and creatinine
Give an example of a sign of a heart transplant rejection
SOB
FLUID RETENTION
What is induction therapy
Medications administered prior to transplant and used when the risk of rejection is higher
Name anti metabolite drugs
Immuran
Cellcept
* used with calcineurin inhibitors
What are side effects of antimetabolite drugs
Bone marrow depression
Rash
Alopecia
GI effects with cellcept
Name calcineurin inhibitor drugs
Cyclosporin
Sirolimus
Tacrolimus
What are the side effects of calcineurin inhibitors
Nephro and hepatotoxic
Neurotoxic
Hyperglycemia
Name corticosteroid drugs
Prednisone
Methylprednisone
Dexamethosone
What are side effects of glucocorticoid drugs
Cushing's syndrome Hyperglycemia GI BLEED HTN OSTEOPOROSIS
What are 3 traits the nurse must have of the dying patient
Compassion
Comfort
Communication
What is imminent death defined as
In the ICU, it is defined as death perceived within 1 hour
What is the salad bowel society
Your beliefs are not shared by anyone
What are the cardinal findings of Brain death
Normothermic
Deep coma
Absence of brain stem reflexes
Apnea
What is confirmatory testing of brain death
Cerebral angiogram
EEG
brain scan
Transcranial Doppler
