NU 246 (EXAM 2)-CARDIO (TRANSPLANT)
Terms
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PANCREAS COMPLICATION
(DURING TRANSPLANT) -
1.DECREASED URINE PH
2.DECREASED AMYLASE
3.HYPERGLYCEMIA*LATE SIGN* - POST TRANSPLANT
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MEDS FOR LIFE!
COST OF MEDS=HIGH
DIARRHEA
PT CAN NOT SKIP DOSE !
HEALTH CARE FOR OTHER PROB: CALL MD
TRANSPLANT MAY NOT ALWAYS BE IN ORIGINAL SPOT
WATCH DIET-AVOID CROWDS - PROGNOSIS OF TRANSPLANTS
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75 PERCENT OF RENAL HAVE REJECTION
95 PERCENT REINFECTED W/ HEP C W/IN MONTHS IF PREVIOUSLY HAD
75 PERCENT HAVE 3 YR SURVIVAL
PANCREAS-SUCCESSFUL WHEN NO LONGER NEEDS INSULIN
LUNG-ADDS 1O YRS TO LIFE W/ CYSTIC FIBROSIS -
HEART COMPLICATION
(DURING TRANSPLANT) -
1.DYSRYTHMIAS
2.LOW BP
3.WEAKNESS
4.S/S OF LOW CARDIAC OUTPUT - WHAT SHOULD BE ADMINISTERED DURING TRANSPLANT?
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HIGH DOSES OF IV CORTICOSTEROIDS
ANTILYMPHOCYTE GLOBULIN (ATGAM)
T-CELL MONOCLONAL ANTIBODY
-SOME S/S SIMILAR TO SE OF MEDS, SO MUST THOROUGHLY ASSESS - CHRONIC REJECTION
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OCCURS MONTHS TO YRS
-PROGRESSIVE LOSS OF FUNCTION
-GRADUAL
-IRREVERSIBLE
-S/S OF CHRONIC ILLNESS - PT IS USUALLY ON 1 OF THESE 3 DRUGS POST TRANSPLANT
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1.CYCLOSPORINE (SANDIMMUNE,NEORAL)
2.TACROLIMUS(PROGRAF)
-CONTRAINDICATED W/ LUNG
3.MYOPHENOLATE MOFETIL (CELLCEPT)
AND PREDNISONE - PRE-OP CARE FOR DONOR
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WORK UP
-TX AS MANY PROBLEMS BEFORE TRANSPLANT - IMMEDIATE POST OP CARE
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ORGAN DEPENDENT
-CRITICAL CARE:
HEMODYNAMIC MONITORING,CHECK INFECTION,REJECTION,HEMORRAGE - COMPLICATIONS OF TRANSPLANTS
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BLEEDING-LEAK AT ANASTOMOSIS
INFECTION-*COUGH AND DEEP BREATHE*LEADING CAUSE OF DEATH
REJECTION-PUT ON MEDS TO PREVENT T-LYMPHOCTYES FROM ATTACKING NEW ORGAN
-PUT ON IMMUNOSUPPRESSANTS*PREDNISONE* -
HYPER ACUTE REJECTION
DURING TRANSPLANT -
GRAFT FAILURE
MINUTES-->HRS
FOREIGN ANTIGEN
T-LYMPHOCTYES ATTACK ORGAN -
ACUTE REJECTION
DURING TRANSPLANT -
MOST COMMON
1 WEEK- 3 MONTHS
S/S APPEAR SUDDENLY BUT CAN STALL PROCESS W/ IMMUNOSUPPRESSANTS
-LOW GRADE FEVER -
KIDNEY COMPLICATION
(DURING TRANSPLANT) -
1.INCREASED CREATININE, BUN
2.DECREASED U/O
3.INCREASED BP
4.FLU-LIKE ILLNESS
5.WT GAIN-SUDDEN DEPENDENT EDEMA -
LIVER COMPLICATION
(DURING TRANSPLANT) -
1.RUQ TENDERNESS
2.INCREASED LFS (LIVER FCN STUDIES) - CRITERIA FOR ORGAN TRANSPLANTATION
- ?
- BENEFITS OF ORGAN TRANSPLANTATION
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-OVER 30 PARTS OF BODY CAN BE TRANSPLANTED
-COST EFFECTIVE
-IMPROVES QUALITY OF LIFE - UNOS
- UNITED NETWORK FOR ORGAN SHARING
- ETHICS OF ORGAN TRANSPLANTATION
- ORGANS DO BETTER WHEN TAKEN OUT OF A LIVE PERSON
- NSG FOR CORNEA DONOR
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-INCREASE BED 30 DEGREES
-ICE PACK ON EYES
-DROPS IN EYES - RISKS TO LIVING DONOR
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-RISK OF BLEEDING
-GOOD--->LIVER REGENERATES IF 1/2 TAKEN OUT
-NOT A RISK TO GIVE BONE MARROW - COMPATIBILITY DEPENDS ON
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DEPENDS ON ORGAN
BLOOD TYPE A-B-O
-MUST BE SAME BLD TYPE
HLA(HUMAN LEUKOCYTE ANTIGEN TYPING) - RECIPIENT SELECTION DEPENDS ON
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DEPENDS ON DISTANCE
-HOW FAST A PERSON CAN GET TO PLACE
-HEART IS ONLY GOOD FOR 4 HRS