A patient is started on immunosuppressant drugs after kidney transplantation and will be taking azathioprine [Imuran] as part of the drug regimen
The patient asks the nurse why it is necessary to have a specimen for a complete blood count drawn at the beginning of therapy and then pe-riodically thereafter. The nurse explains that azathioprine can alter blood cells and tells the patient to report: a. alopecia.
b. easy bruising.
c. fatigue.
d. gastrointestinal (GI) upset.
B
Azathioprine can cause bone marrow suppression, resulting in neutropenia and thrombocytopenia; therefore, a CBC must be evaluated at baseline and periodically thereafter. Patients who have low platelet counts bruise easily, so this symptom should be reported. Alopecia occurs with azathioprine but is not a life-threatening side effect. Fatigue is not a common adverse effect. GI side effects occur but are not life threatening.
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