A client is receiving tacrolimus (Prograf) to prevent organ rejection. Which of the following is a nursing considerations associated with this medication?
1. Give with cyclosporine (Sandimmune).
2. Assess for hypoglycemia.
3. Give with grapefruit juice.
4. Assess platelet count for thrombocytopenia.
4
Rationale: Tacrolimus (Prograf) is an alternative to cyclosporine for prevention of organ rejection in clients receiving an organ transplant. It should never be given with cyclosporine because of its toxic effects on the kidney. This medication will cause hyperglycemia (not hypoglycemia). Grapefruit juice can increase tacrolimus levels so it should be avoided to prevent toxicity. Tacrolimus suppresses the bone marrow, so it can cause anemia, thrombocytopenia, and neutropenia.
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