A nurse is discussing kidney transplant with a client who has end-stage renal disease (ESRD). Which of the following should the nurse identify as a contraindication for this treatment?
Breast cancer survivor for 8 years.
65 years of age.
Alcohol use disorder.
Pacemaker.
The Correct Answer is C
Choice A rationale
A breast cancer survivor for 8 years without recurrence is generally considered for transplantation if otherwise healthy.
Choice B rationale
Age 65 is not an absolute contraindication for kidney transplantation. Many factors such as overall health status are considered.
Choice C rationale
Alcohol use disorder is a contraindication due to the potential for poor adherence to post-transplant care and medication, as well as the increased risk of liver damage.
Choice D rationale
Having a pacemaker is not an absolute contraindication for a kidney transplant; individuals with pacemakers can still be eligible for transplantation if otherwise healthy.
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Correct Answer is D
Explanation
Choice A rationale
An HbA1c level of 5.7% or below indicates normal glucose tolerance, not impaired glucose tolerance.
Choice B rationale
In type 1 diabetes mellitus, the beta cells are destroyed, and dietary changes alone cannot restore insulin production.
Choice C rationale
Type 1 diabetes mellitus is a chronic condition and is not considered reversible.
Choice D rationale
Type 1 diabetes mellitus is characterized by the autoimmune destruction of beta cells in the pancreas, leading to an absolute lack of insulin production.
Correct Answer is B
Explanation
Choice A rationale
Discussing hyperglycemia manifestations is not specific to Addison's disease, as Addison's is characterized by hypoglycemia due to cortisol deficiency.
Choice B rationale
Teaching the parents about cortisol replacement therapy is essential in Addison's disease management. Cortisol deficiency is the primary issue, so educating on proper administration and monitoring is crucial.
Choice C rationale
Placing the child on a low-sodium diet is not recommended because Addison's disease often involves salt wasting, so adequate sodium intake is necessary.
Choice D rationale
Monitoring for fluid volume excess is more applicable to conditions like heart failure, not Addison's disease, which is associated with dehydration and hypovolemia.