Page 1852 - Saunders Comprehensive Review For NCLEX-RN

5. Ensure that the recipient is free of any infections.
6. Assess renal function studies.
7. Encourage discussion of feelings of the live donor and
the recipient.
8. Provide psychological support to the live donor,
NHBD, or cadaver donor family and to the recipient.

D. Postoperative interventions for the recipient

1. The transplanted kidney is placed in the anterior iliac
fossa; usually the recipient’s diseased kidneys are left
in place, except for those with polycystic kidney
disease, in which the kidneys are often very enlarged
and painful.
2. Urine output usually begins immediately if the donor
was a living donor; it may be delayed for a few days
or more with other donor types.
3. Hemodialysis may be performed until adequate
kidney function is established.
4. Monitor vital signs and for signs of complications such
as rejection, thrombosis, renal artery stenosis, or
wound problems.
5. Monitor urine output hourly; immediately report an
abrupt decrease in output.
6. Monitor IV fluids closely; for the first 12 to 24 hours,
IV fluid replacement is based on hourly urine output.
7. Administer prescribed diuretics and osmotic agents.
8. Monitor daily weight to evaluate fluid status.
9. Monitor daily laboratory results to evaluate renal
function, including hematocrit, BUN, and serum
creatinine levels, and monitor urine for blood and
specific gravity.
10. Position the client in a semi-Fowler’s position to
promote gas exchange, turning from the back to the
nonoperative side.
11. Monitor urinary catheter patency; the urinary catheter
usually remains in the bladder for 3 to 5 days to allow
for anastomosis healing; it is removed as soon as
possible to prevent infection.
12. Note that urine is pink and may be bloody initially but
gradually returns to normal within several days to
weeks.
13. Notify the PHCP if gross hematuria and clots are
noted in the urine.
14. Monitor the 3-way bladder irrigation, if present, for
clots; irrigate only if an PHCP’s prescription is
present.
15. Maintain aseptic technique and monitor for infection.
16. Maintain strict aseptic technique with wound care.

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