A nurse reviews these laboratory values of a client who returned from kidney transplantation 12 hours ago:
Sodium
136 mEq/L
Potassium
5 mEq/L
Blood urea nitrogen (BUN)
44 mg/dL
Serum creatinine
2.5 mg/dL
What initial intervention would the nurse anticipate?
a.
Start hemodialysis immediately.
b.
Discuss the need for peritoneal dialysis.
c.
Increase the dose of immunosuppression.
d.
Return the client to surgery for exploration.
ANS: C
The client may need a higher dose of immunosuppressive medication as evidenced by the elevated BUN and serum creatinine levels. This increased dose may reverse the possible acute rejection of the transplanted kidney. The client does not need hemodialysis, peritoneal dialysis, or further surgery at this point.
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