A client who underwent kidney transplantation 7 days ago has developed the following signs:
urine output, 50 mL/12 hr; temperature, 102.2° F (39° C); lethargy; serum creatinine, 2.1 mg/dL; blood urea nitrogen (BUN), 54 mg/dL; and potassium, 5.6 mEq/L. Which initial intervention does the nurse anticipate for this client?
a. Immediate hemodialysis
b. Increased dose of immune suppressive drugs
c. Initiation of IV antibiotics after cultures are obtained
d. Placement of a catheter for peritoneal di-alysis
B
Oliguria, lethargy, elevated temperature, and increases in serum electrolyte levels, BUN, and creatinine, 1 week to 2 years post-transplantation are hallmarks of acute rejection, which can be reversible with increased immune suppressive therapy. The client does not need hemodialysis, peritoneal dialysis, or antibiotics at this point.
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