Page 1853 - Saunders Comprehensive Review For NCLEX-RN

17. Monitor for bowel sounds and for the passage of
flatus; initiate a specific diet and oral fluids as
prescribed when flatus and bowel sounds return
(usually, fluids, sodium, and potassium are restricted
if the client is oliguric).
18. Maintain good oral hygiene, monitoring for stomatitis
and bacterial and fungal infections.
19. Encourage coughing and deep-breathing exercises.
20. Administer immunosuppressive medications as
prescribed.
21. Assess for signs of organ rejection.
22. Promote relationship between the live donor and
recipient.
23. Monitor both the donor and the recipient for
depression.
24. Provide the recipient with instructions following the
kidney transplantation (Box 54-9).
25. Assist the recipient to cope with the body image
disturbances that occur from long-term use of
immunosuppressants.
26. Advise the recipient of available support groups.

E. Graft rejection

1. Assessment (Box 54-10)
2. Hyperacute rejection
a. Hyperacute rejection occurs within 48
hours after the transplant.
b. Intervention: Removal of rejected
kidney
3. Acute rejection
a. Occurs within 1 week postoperatively,
but can occur any time post-
transplantation.
b. Intervention: Potentially reversible with
increased immunosuppressive
therapy.
4. Chronic rejection
a. Occurs slowly months to years after
transplant.
b. Interventions: Immunosuppressive
medications and dialysis if necessary.

Except in identical twin donors and

recipients, the major postoperative complication
following renal transplant is graft rejection.
XII. Cystitis (Urinary Tract Infection)

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