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Details

Med surg III UNIT 6
objective 5 Transplantation
45
Nursing
Undergraduate 1
04/08/2012

Additional Nursing Flashcards

 


 

Cards

Term
What are the types of transplants?
Definition

Autograft

Heterograft (Xenograft)

            Allograft

Term

What is an Autograft

 

Definition

tissue that is donated by, and grafted to,

the same person

Term
What is an Allograft
Definition
donation between members of the same species
Term

What is a Heterograft (Xenograft)

Definition
donation between members of different species
Term

What are the diffrent types of donors?

Definition

Live

Cadaveric

Term
What are the two groups of Cadaveric donors?
Definition

Cardiac death-not best for organ donnors but tissue are still good.

 

Brain death- main organ donnors

Term

What are the cardinal findings in brain death

Definition

i.  Coma

ii.  Cranial reflexes

iii.  Apneic 

Term
What qualifys a pt as being in a coma
Definition

no responses to stimuli

Glasgow < 8

Term
What Cranial reflexes are checked?
Definition

pupillary reflexes- CN 3- PERRLA

Oculocephalic- CN 3,4,5- turn head eyes should look opisit

Oculovestibular- CN 8- cold water in ear should caus nystagmus

Pharyngeal and Tracheal- CN 9,10- cough or gag reflex

Term
What is the Apnea test
Definition

pt is removed from resp. suport to see if they have any drive to breath. 

falure to atempt is a + apnea test

Term
How is brain death confirmed
Definition

cerebral angiography

electroencephalogram

transcranial doppler ultrasound

technetium-99 brain scan

samatosensory evoked potentials

 

Term
What is the first step to organ and tissue donation?
Definition

obtain consent- done by physician or IORS team.

Nurse checks to see it is in the chart

Term
What factors increas the likelyhood the family will consent to organ donation
Definition

donation is not requested at the same time that death is declared

requestor is perceived as sensitive to their needs

they are approached in private, quiet place

Term

What is done to help Organ Preservation

Definition

Keep Pt Hemodynamic stability

Ventilation maintained

Fluid and Electrolyte balance

Body temperature maintained

 

Term

When a pt is told they are getting a new kidney you should expect them to be energetic and joyful in the time leading up to the surgery.

 

True or False?

Definition

False

many pts go through a grieving process/ depression when told they are going to recive a new organ ,or shortly after surgery

Term
When is bleeding from the sight of the transplant most likely to occur?
Definition
first 24 hours
Term
What is the most common type of compication after a transpant
Definition
rejection
Term
What are the types of rejection 
Definition

Hyperacute

Acute

Chronic

Term

What is Hyperacute rejection

Definition

occurs in minutes to hours of transplant

this should not occur with proper tissue typing

results in the admediat failure of the organ

most often fatal

Term
what is acute rejection
Definition

occures days to months after transplant

host vs graft- most common type

prevented by immunosuppressants

gradded 1-4. 4 most severe

Term
What is chronic rejection
Definition

rejects over years, eventually leads to organ failure

can fluctuates from grade 1-4

 

Term

What Health problems post-transplant are usually secondary to immunosupression

Definition

Infection

Organ dysfunction

Malignancy

Medication induced problems

Term

What is Induction therapy

Definition

initial immunosuppression after surgery

higher doeses

Typically IV meds

Term

What is Maintainance therapy

 

Definition

routine drugs

usaly 2-3 types

weened to the lowest does possible

Term

What is Anti-Rejection therapy

 

Definition

high does of meds for acute phases of rejection

in hospital and IV meds

will go back to maintainence does

 

Term

Why will a transplant pt recive Corticosteroids

Definition
used for maintainence and anti-rejection
Term
What are the common effects of Corticosteroids on the CNS
Definition
  • anxiety, mood swings, insomnia, and headache.
Term
What are the common effects of Corticosteroids on the GI
Definition
  • nausea, vomiting, increased appetite, weight gain, and dyspepsia.
Term
What are the common effects of Corticosteroids on the Endocrine system
Definition
  • hyperglycemia, menstrual irregularities, suppression of pituitary ACTH release, 
Term
What are the common effects of Corticosteroids on the skin
Definition
  • acne, delayed healing of wounds
Term
What are the common effects of Corticosteroids on infection
Definition
Increased susceptibility to infections
Term
What are the common effects of Corticosteroids with long term use
Definition
can lead to Cushingoid characteristics such as buffalo hump, moon face and trance obesity.  May also see loss of muscle mass and thinning extremities.
Term
What are the common effects of Corticosteroids on lippipid levels
Definition
  • Hyperrlipidemia and thrombus formation may occur with long-term therapy.
Term
What are the common effects of Corticosteroids on papathyroid function
Definition
increased parathyroid activity and calcium loss from bones which increase risk of osteoporosis
Term
What are the common effects of Corticosteroids on bone
Definition

increase risk of osteoporosis

May suppress bone growth

Term

prednisone should be given with food or  an antacid.


True or False?

Definition
True
Term

Your pt is going to recive prednisone.  You need to teach him about the S/S of acute adrenal insufficiency.What are the S/S

 

 

Definition
anorexia, hypoglycemia, lethargy, restlessness 
Term

What is an example of a Calcineurin Inhibitor

Definition
Cyclosporine
Term
Why would your transplant pt be on Calcineurin 
Definition
as a maintainence drug
Term

In transplant pts you will typlicaly see Calcineurin Inhibitors given with Antimetabolites.

 

True or False

 

 

Definition

False

 

They use one class or the other for maitainence therapy

Term

When would your pt need Antibody therapy

 

Definition
for induction or anti-rejection therapy
Term
What type of cells do monoclonal drugs attack
Definition
B and T lymphocytes
Term
What type of cells do polyclonal drugs attack
Definition
all forms of T lymphocytes
Term
What pretreatment needs to done when giving  monoclonal and polyclonal meds?
Definition

anti-pyretic

anti-histamine

anti-emetic

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