A nurse is teaching her client about cyclosporine therapy following a recent liver transplant. What statement by the client indicates further teaching is needed?

Question

1. "I might experience a decrease in urinary flow."
2. "I can take ibuprofen (Advil) for a headache, but I have to be very careful."
3. "I can take this drug with any fluid as long as it is at the same time every day."
4. "I will need to come into the clinic for periodic blood counts."

Answer 1

3

Rationale 1:"I might experience a decrease in urinary flow" is incorrect because the primary adverse effect of cyclosporine occurs in the kidney, with up to 75% of clients experiencing reduction in urine flow.
Rationale 2:"I can take ibuprofen (Advil) for a headache, but I have to be very careful" is incorrect because while cyclosporine can damage the kidneys, other nephrotoxic drugs such as amphotericin B, NSAIDs, or aminoglycosides should be administered with great caution.
Rationale 3:The client should avoid grapefruit and grapefruit juice.
Rationale 4:"I will need to come into the clinic for periodic blood counts" is incorrect because frequent laboratory tests of kidney function are necessary.

Global Rationale: The client should be instructed to avoid and eliminate grapefruit and grapefruit juice from the diet while on the drug. The client will experience a decrease in urine flow and should have laboratory values checked. Caution with cyclosporine and other drugs nephrotoxic to the kidney such as amphotericin B, NSAIDs, or aminoglycosides.