A patient who had a bone marrow transplant 10 days ago develops a maculopapular rash on the palms of both hands and the soles of the feet. The patient complains of severe abdominal pain with bloody diarrhea
The nurse would anticipate providing care for which condition? 1. Graft-versus-host disease
2. Chronic graft rejection
3. Acute tissue rejection
4. Hyperacute tissue rejection
1
Rationale 1: Rash and gastrointestinal symptoms can be symptoms of graft-versus-host disease.
Rationale 2: Chronic tissue rejection occurs from 4 months to years after the transplant of new tissue. Transplanted organs slowly fail when chronic graft rejection occurs.
Rationale 3: Acute tissue rejection, the most common type of rejection, occurs between 4 days and 3 months after the transplant. Acute rejection is mediated primarily by the cellular immune response, resulting in transplant cell destruction. The patient demonstrates manifestations of the inflammatory process, with fever, redness, and swelling.
Rationale 4: Hyperacute rejection occurs when there is a preexisting antibody to the graft tissue. Manifestations are rapid, occurring within minutes to hours.
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