Page 2183 - Saunders Comprehensive Review For NCLEX-RN

c. Prepare the client for radiation therapy
or chemotherapy as prescribed.
d. Administer immunotherapy, as
prescribed, to stabilize the immune
system.
XIV. Posttransplantation Immunodeficiency
A. Description
1. Secondary immunodeficiency is immunosuppression
caused by therapeutic agents.
2. The client must take immunosuppressive agents for
the rest of his or her life posttransplantation to
decrease rejection of the transplanted organ or tissue.
B. Diagnosis and monitoring of posttransplantation clients
1. Check renal and hepatic function.
2. Monitor the complete cell count with differential to
determine signs of infection.
3. Assess all body secretions periodically for blood.

C. High-risk clients

1. Clients with a history of malignancy or premalignancy
have an increased susceptibility to malignancy if
immunosuppressed.
2. Clients with recent infection or exposure to
tuberculosis, herpes zoster, or chickenpox have a high
risk for severe generalized disease when on
immunosuppressive agents.

D. Assessment

1. Assess for signs of opportunistic infections.
2. Assess nutritional status.
3. Assess for signs of rejection (signs will depend on the
organ or tissue transplant).
E. Interventions
1. Strict aseptic technique is necessary.
2. Provide teaching regarding asepsis and the signs of
infection and rejection.
3. Institute protective isolation precautions as necessary.
4. Provide psychosocial support as needed.
5. Provide client teaching about immunosuppressants.

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