The nurse preparing to administer the initial dose of an immunosuppressant agent for a client recovering from organ transplantation would make certain that screening has been performed to rule out:

Question

1. electrolyte imbalance.
2. cardiomegaly.
3. anemia.
4. infectious processes.

Answer 1

Correct Answer: 4
Rationale 1: An electrolyte balance would not be an indication to withhold an immunosuppressant.
Rationale 2: Cardiomegaly would not need to be ruled out prior to administration of an immunosuppressant.
Rationale 3: The client with anemia could benefit from an immunosuppressant, especially if the client has hemolytic anemia.
Rationale 4: The priority would be to rule out infectious processes because administration of an immunosuppressant could exacerbate an infection.
Global Rationale: Prior to the initiation of immunosuppressant therapy, it is critical that the patient be carefully assessed to rule out active infections. This includes screening for viruses such as cytomegalovirus (CMV), hepatitis B and C viruses, Epstein-Barr virus (EBV), VZV, HIV, and herpes simplex virus (HSV). Electrolyte imbalance, cardiomegaly, and anemia do not need to be ruled out prior to this therapy.