A patient with a liver transplant has been receiving cyclosporine (Sandimmune) for 6 months. The nurse reviews this patient's laboratory results and notes a sharp increase in the blood urea nitrogen (BUN) and serum creatinine
Vital signs are normal, and the patient reports no discomfort. What does the nurse suspect?
a. Hepatotoxicity
b. Infection
c. Organ rejection
d. Nephrotoxicity
ANS: D
An elevation of BUN and serum creatinine is an indication of nephrotoxicity, which occurs in 75% of patients taking cyclosporine. Hepatotoxicity would cause elevations in liver enzymes, not the BUN and creatinine. Infection would be associated with fever. Organ rejection of a renal transplant would cause elevation in the BUN and creatinine but also would cause tenderness at the graft site and fever.
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