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Adults 2 Final > Immune (Transplants) > Flashcards

Immune (Transplants) Flashcards

1
Q

What is a Autologous transplant:

A

from themselves (stem cells transplants)

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2
Q

4 types of transplants

A

Autograft: take from one part of body and put it on another (skin, hair, bone)
Allograft: Between members of same species (most common, human-human, kidney, heart, lung, liver)
Isograft: Between identical twins
Xenograft: monkey, pig, cow transplant

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3
Q

What two organs can be partially transplanted

A

Liver
Lung lobes

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4
Q

Highest demand for _______, ________, _________.

A

kidneys, hearts, livers

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5
Q

When can a deceased donor donate organs

A

Usually from brain death. Must have sufficient CV function to perfuse organs

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6
Q

NURSE’S ROLE IN DETERMINING ELIGIBILITY FOR DONATION

A

follow institution policy to determine if a candidate
contact the local organ donation organization (LifeNet Health)
WE DO NOT TALK TO THE FAMILY ABOUT TOPIC OF ORGAN DONATION

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7
Q

WHAT TESTS ARE DONE TO DETERMINE ELIGIBILITY TO RECEIVE AN ORGAN

A

HLA: human leukocyte antigen (Helps the immune system distinguish between the body’s own cells and foreign substances)
Antibody panels
ABO compatibility
Assessment for comorbidities

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8
Q

What happens after someone receives a transplant organ

A

critical care immediately post-op

Must have immunosuppressive drug levels checked to ensure that immunosuppression is therapeutic

Possible organ biopsies after hospitalization (to ensure immune system isn’t breaking it down)

Immunosuppressants start on high dosages that are reduced over time

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9
Q

T/F: You need to be put on immunosuppressants if you receive a autograft

A

False. Immunosuppression not needed if receiving an autograft

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10
Q

What is the immunosuppressant drug regiment people are put on for solid organs

A

Triple therapy

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11
Q

Name a Calcineurin Inhibitor commonly used in Triple therapy

A

Tacrolimus : Inhibit communication with the Tcells to other parts of the immune system

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12
Q

Name a Cytotoxic drug commonly used in Triple therapy

A

Mycophenolate mofetil: Keeps your T and B cells from replicating

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13
Q

What are the three drugs used in Triple therapy

A

Calcineurin Inhibitors
Corticosteroids
Cytotoxic drugs

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14
Q

What drug do you expect a transplant patient to be on the rest of their lives?

A

Corticosteroids

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15
Q

What Sx should you report for a transplant pt

A

Signs of infection: fever, malaise, flu-like symptoms
Check inflammation: ESR, CRP
Manifestations of rejection: Pain at the site, flu-like symptoms

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16
Q

T/F: A patient on immunosuppressants will have a high or low WBC count?

A

low WBC

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17
Q

What is hyperacute rejection

A

Occurs within 24 hours of transplantation
Individual had pre-existing antibodies against the organ
Transplanted organ must be removed

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18
Q

What is acute rejection

A

Occurs within first 6 months
Can normally be curbed with increase in immunosuppression
Common to have at least 1 bout with rejection

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19
Q

What is chronic rejection

A

Occurs over months or years with repeated acute rejection episodes
Irreversible
Supportive therapy: may or may not receive another organ

20
Q

What is GVHD

A

ORGAN TRANSPLANT COMPLICATION-GRAFT VERSUS HOST DISEASE

occurs within a month of transplantation

T cells from the donated organ or tissue infiltrate the system of the recipient and start to attack the host’s body

Can lead to SKIN OR LIVER disease which can become fatal

Most effectively treated with IMMUNOSUPRESSION

21
Q

What is the Bruce Tucker case

A

First ever successful heart transplant. Took heart from black man and never spoke to family about it.

22
Q

What is the Uniform Anatomical Gift Act-1968

A

Allowed individuals to gift their organs

23
Q

What is Uniform Determination of Death Act-1980

A

Provided a definition of brain death

24
Q

What is National Organ Transplant Act-1984

A

Created more regulation and the organ procurement networks (tried to make more equitable)

25
Q

What is the Cole Hartman Case

A

Child drowned in washing machine, anesthesiologist tried to make child brain dead so they could donate their organs.

26
Q

T/F: The ability to pay for transplant and needed services can affect eligibility

A

True. Socioeconomic status is considered when deciding who gets an organ

27
Q

What do you need to do to a kidney recipient before they can receive a kidney transplant

A

If recipient is on dialysis, will be dialyzed very close to procedure to correct electrolyte and fluid balance

28
Q

Nursing considerations for kidney transplant patients

A

Should see diuresis in the first few hours
Frequent labs
Monitor for clots in the catheter
start triple therapy
I/O recording

29
Q

The nurse should report the following sx to the provider for a kidney transplant patient

A

Pain at transplant site (back below ribcage), decreased urine output, flu-like sx, UTI sx

30
Q

T/F: You only donate one lung at a time to a recipient because you only need one lung

A

False. You can donate a part of a lung, and entire lung, or two lungs depending on what the recipient needs

31
Q

Nursing considerations for lung transplant patients

A

Will be on the ventilator post-op (frequent ABGs done)

on triple therapy

High risk for lung infections due to presence of endotracheal tube (ETT) and immunosuppression

32
Q

The nurse should report the following sx to the provider for a lung transplant patient

A

Dyspnea
Cough
O2 desaturation
flu-like sx

33
Q

Three Major Types of STEM CELL TRANSPLANTs:

A

Allogenic
Syngeneic
Autologous

34
Q

Allogenic

A

stem cells Get from another individual

35
Q

Autologous

A

stem cells Get from themselves

36
Q

Syngeneic

A
37
Q

What are the most common diseases in which you would extract stem cells?

A

Used primarily for those with blood-borne cancers such as leukemia, multiple myeloma

38
Q

What drug is given to increase number of hematopoietic stem cells

A

G-CSF

39
Q

What is apheresis

A

Stem cell harvesting via spinning blood and picking out stem cells, and freezing them. Need certain amount of stem cells, may take longer from some than others.

40
Q

Why use high-dose chemotherapy for blood cancer?

A

Kill all bone marrow creating cancerous blood, then transplant stem cells back in

only works for 3-5, sometimes 10 years. Will likely need another transplant.

41
Q

What should you monitor for a patient currently undergoing high dose chemotherapy for leukemia?

A

Become pancytopenic
CBC: low blood count, low iron, low platelets
become anemic, high risk for infection, high risk for bleeding
As soon as pt has a fever, you infuse antibiotics

Chemistry panel

Get blood products as needed.

42
Q

What should you monitor for a patient who received a donor stem cell transplant

A

GRAFT VERSUS HOST DISEASE (GVHD): More likely with stem cell transplant because the stem cells can create T and B cells that will attack the individual

43
Q

There is a ___ hour window for heart transplantation to take place after it has been removed from the donor

A

4

44
Q

s/s of heart transplant rejection

A

JVD, SOB, Edema, cardiac dysrhythmias, flu-like sx

45
Q

T/F: Many deceased donor livers are split in two and given to two different recipients

A

true

46
Q

What labs do you monitor LIVER TRANSPLANT POST-OP

A

Monitor LFTs (elevated can mean rejection)

bleeding times (PTT, INR)

CBC (anemia)

Sx: jaundice, ascites, indc of liver failure

Triple therapy
If have Hepatitis they’ll be treated with antiviral post-op

Adults 2 Final (3 decks)

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