A patient who received a kidney transplant 7 years ago is seen for increasing blood pressure and proteinuria. The nurse conducts additional assessment for which complication?
1. Chronic kidney rejection
2. Acute kidney rejection
3. Renal artery stenosis
4. Pyelonephritis
1
Rationale 1: Chronic rejection may develop months to years following a transplant. The presenting manifestations of progressive azotemia, proteinuria, and hypertension are those of progressive renal failure.
Rationale 2: Acute rejection most commonly occurs in the weeks immediately following a transplant.
Rationale 3: Renal artery stenosis manifests with a bruit over the surgical anastomosis site.
Rationale 4: Pyelonephritis manifests with abdominal discomfort and low-grade fever.
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