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NSG 210 Test 3 Study Guide

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Unformatted text preview: Cyclosporin is a widely used immunosuppressant but has some major side effects  ­Clinical manifestations of rejection include: Tachycardia Fever RUQ pain or flank pain decreased bile pigment or volume increasing jaundice Indications: for liver transplantation include irreversible advanced chronic liver disease, fulminant hepatic failure, metabolic liver diseases & some hepatic malignancies. Ethical issues: arise concerning liver transplantation. Some believe preference should be given to pts who need liver transplants but do not have a hx of socially unacceptable behavior (excessive alcohol use, hepatitis b/c of sexual promiscuity, etc.)  ­Living donor transplantation is becoming more common, although it is controversial b/c it is considered a major surgical procedure for the donor Pre ­operative Nursing interventions  ­Malnutrition, massive ascites & fluid/electrolyte disturbances should be treated pre ­op to increase likelihood of a successful outcome  ­Continue to monitor neurologic status, peritonitis & temperature.  ­Report signs of clotting problems Post ­operative nursing interventions  ­Pt should be on neutropenic precautions & as free from bacteria, fungi & viruses as possible.  ­Mean arterial & pulmonary artery pressures are monitored continuously.  ­Cardiac output, central venous pressure, pulmonary capillary wedge pressure, arterial & mixed venous blood gases, O2 sats, oxygen demand/delivery, urine output, heart rate & B/P are monitored to evaluate the pt’s hemodynamic status  ­Liver function tests, electrolyte levels, coagulation profile, chest x ­ray, ECG, & fluid output are also monitored closely.  ­An endotracheal tube will be in place so su...
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