Page 1903 - Saunders Comprehensive Review For NCLEX-RN

6. Abdominal cramps
7. Diarrhea
8. Urinary urgency
9. Bronchoconstriction
10. Transient complete heart block

C. Nursing considerations

1. Administer on an empty stomach, 1 hour before or 2
hours after meals to lessen nausea and vomiting.
2. Never administer by the intramuscular or IV route.
3. Monitor intake and output.
4. Monitor for increased bladder tone and function.
5. Monitor for cholinergic overdose (excessive salivation,
sweating, involuntary urination and defecation,
bradycardia, and severe hypotension).
6. Have atropine sulfate (antidote for cholinergic
overdose) readily available for IV or subcutaneous
administration.

A cholinergic such as bethanechol chloride is not given to a

client who has a urinary stricture or obstruction.
VII. Medications for Preventing Organ Rejection (Box 55-6)
A. Medications include immunosuppressants, corticosteroids,
cytotoxic medications, and antibodies.
B. Some medications may be used in combination to produce
different actions on the immune system; combination therapy also
allows for administration of the medications in lower doses,
reducing the possibility of adverse effects.

C. Cyclosporine

1. Cyclosporine inhibits calcineurin and acts on T
lymphocytes to suppress the production of
interleukin-2, interferon-γ, and other cytokines.
2. Cyclosporine may be used to prevent rejection of
allogeneic kidney, liver, and heart transplants.
3. Prednisone may be administered concurrently.
4. Oral administration of cyclosporine is preferred; IV
administration is reserved for clients who cannot take
the medication orally.
5. Blood levels of the medication should be measured
regularly because of its nephrotoxic effects.

6. The most common adverse effects are

nephrotoxicity, infection, hypertension, tremor, and
hirsutism.

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