renal transplant/teaching plan

Order Description

 

respond to 3 of my classmates discussion post with at least 250 words. I need to add on to the discussion to further the discussion by adding information.. maybe
state what you thought was interesting and add information to further discussion.
The original assignment: 68-year-old male S/P renal transplant 8 days ago. He lives at home with his daughter and three young grandchildren. Transplant is successful
so far, with no complications evident. Physician writes an order to provide education and prepare patient for discharge in 2 days. The medications ordered are
Cyclosporine oral solution 500mg/day and Prednisone 40mg po BID. He is very attentive and eager to learn. He has many questions. He asks “what do I need to know about
these medications? How do I take them? Can I still take my health supplements? “.
How would you respond to him? What would you include in his educational plan?

Discussion 1:
Providing patient education to a discharging patient can be overwhelming for some. For this patient who is eager to learn and has already asked a question for further
care. This shows me the patient is ready to learn and will obtain the information given well. Knowing the patient is mentally prepared to be taught I would make time
and sit down with the patient and go over the education that needs to be presented.
Patient education for a renal transplant patient
Medications
Cyclosporine: used to prevent organ rejection in people who have received a liver, kidney, or heart transplant. Cyclosporine works by weakening the immune system to
help your body accept the new organ. Cyclosporine is an oral solution, 500mg once daily. Mixing it in a glass container with milk, chocolate milk, or orange juice may
help with the taste. You should take this medication at the same time each day to benefit more from it. You may take this medication with or without food, also avoid
eating grapefruit or drinking grapefruit juice while using this medication. Grapefruit can increase the chance of side effects while taking Cyclosporine. Side effects
of Cyclosporine include shaking, headache, dizziness, unusual growth of body hair, nausea/vomiting, diarrhea, stomach upset, or flushing may occur. Any symptoms that
last or get worse, tell your doctor or pharmacist.
Prednisone: known as corticosteroids is a steroid that will decrease your immune system’s response to various diseases to reduce symptoms with swelling and allergic
reactions. take medications by mouth, 2 daily. To prevent upset stomach, Prednisone should be taken with food or milk. Follow dosing schedule carefully and do not stop
taking this medication without consulting with your doctor. Side effects may include; weakness, weight loss, nausea, muscle pain, headache, tiredness, or dizziness. If
symptoms last or get worse call your doctor.
Please provide the doctor a list of the medications, vitamins, and herbs you take at home.
Self-care:
Rest as needed: slowly start to do more each day.
Drink liquids as directed: the doctor will give an amount that you can drink a day and fits your liquid intake the best.
Eat a healthy diet: ask if you need to be on a special or low-salt diet.
Maintain a healthy weight: ask how much you should weigh.
Exercise: this may help increase your energy levels.
Do not drink or smoke: these types of habits can harm your new kidney.
Ask about vaccines before receiving one, may decrease your ability to fight an infection.
Check blood sugars and blood pressure: record the results to your healthcare provider.
Bathing with stitches: gently wash the part of the body that has the stitches. Do not rub on the stitches, pat the area gently with a towel. Put on a clean, new
bandage after bathing to prevent infection.

Contact your nephrologist if you have any signs or symptoms that include, you feel you cannot cope with your condition, you have chills, a cough, or feel weak and
achy. You have dizziness, nausea, or vomiting, skin is itchy, swollen, or has a rash, or if you have any questions or concerns about your condition or care.

Discussion 2
In this situation, since he is already home one thing I would go over in his education plan with him is the worry about kidney transplant rejection. This is the
biggest worry with any transplant. This is something that can occur when your immune system attacks the new kidney and thinks of it as a foreign thing and the body
then damages or destroys the kidney (Castro, C. 2007, March). This is something that will happen within the first few weeks to the first few months after the surgery.
Things to go over with the patient on how to keep the new kidney healthy would be to take medicine as directed, exercise regularly, eat healthily, quit smoking if you
smoke, decrease alcohol intake, wear sunscreen, continue check-ups with the doctor (Castro, C. 2007, March). Cyclosporine is a medication used to prevent organ
rejection in a patient that is receiving a transplant. This medication is an immunosuppressant. This medication will suppress the immune system allowing your body to
accept the new organ and not fight it. With taking cyclosporine you want to avoid any grapefruit or and byproducts of grapefruit. This medication is a liquid and
should be drawn up in a syringe provided with the medication. The thing I would want to go over with the patient is that this medication can increase the risk of
developing an infection, or cancer. (Mulder, K. E., Egorin, M. J., & Sawyer, M. B. 2012). Prednisone is also a medication that helps with organ rejection after a
transplant. This medication also lowers the immune system response to protect the new kidney from the body potentially fighting it off. This is an oral medication that
should be taken as prescribed by the doctor. This is a corticosteroid often known as a steroid (West, M. S., Stevens, R. B., Metrakos, P., Foshager, M. C., & al, e.
1998). These medications can be taken with most health supplements but all medications should be told to your doctor and gone over before taking any new medications.

discussion 3:
It is great that he is willing and attentive to learn the information about his discharge plan. In this discharge I want him to know what the medications are that he
is taking. He needs to know what they do, what are the side effects, and what side effects to look out for incase his body is rejecting his transplant despite the
medications. The two medications he is to take are Cyclosporine and Prednisone.
Cyclosporine and cyclosporine (modified) are used with other medications to prevent transplant rejection (attack of the transplanted organ by the immune system of the
person who received the organ) in people who have received kidney, liver, and heart transplants. Cyclosporine and cyclosporine (modified) are in a class of medications
called immunosuppressants. They work by decreasing the activity of the immune system. (MedlinePlus). As an immunosuppressant drug, he will also need to ensure being
careful to not expose himself to anyone that is sick or anything that could cause him to become sick.
Cyclosporine and cyclosporine (modified) both come as a capsule and a solution (liquid) to take by mouth. Cyclosporine is usually taken once a day. It is important to
take both types of cyclosporine on a regular schedule. Take cyclosporine or cyclosporine (modified) at the same time(s) each day, and allow the same amount of time
between doses and meals every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not
understand. Take cyclosporine or cyclosporine (modified) exactly as directed. Do not take more or less of the medication or take it more often than prescribed by your
doctor.Your doctor will probably adjust your dose of cyclosporine or cyclosporine (modified) during your treatment. If you are taking either type of cyclosporine to
prevent transplant rejection, your doctor will probably start you on a high dose of the medication and gradually decrease your dose.Your doctor may also decrease your
dose if you experience side effects of the medication. Tell your doctor how you are feeling during your treatment. (MedlinePlus).
Tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, and nutritional supplements you are taking, or plan to take.
(MedlinePlus).
Cyclosporine and cyclosporine (modified) may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
Headache, diarrhea, heartburn, gas, increased hair growth on the face, arms, or back, growth of extra tissue on the gums, acne, flushing, uncontrollable shaking of a
part of your body, burning or tingling in the hands, arms, feet, or legs, muscle or joint pain, cramps, pain or pressure in the face, ear problems, breast enlargement
in men, depression, difficulty falling asleep or staying asleep. (MedlinePlus).
Prednisone is an immunosuppressant drug used to prevent the body from rejecting a transplanted organ. It is also used to treat certain forms of arthritis, severe
allergies, asthmas, as well as skin, blood, kidney, eye, thyroid and intestinal disorders. Prednisone, a corticosteroid, is similar to a natural hormone produced by
your adrenal glands. It often is used to replace this chemical when your body does not make enough of it. Prednisone inhibits interluekin-1 secretions, resulting in
decreased replication of cytotoxic T cells. It also has a nonspecific anti-inflammatory effect and inhibit granulocyte function, thus limiting damage to an organ in
which the rejection process has already begun. (TransplantLiving).
If he follows the strict guidelines of taking his medications and does everything to ensure a safe and effective transplant, that doesn’t mean that it is 100%
guaranteed to work. He will still need to follow up with his provider for any possible adverse effects r/t the drugs or from the transplant.