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 C
Explanation
Choice A rationale
Bubbling in the water seal chamber with exhalation indicates that air is still being removed from the pleural space, which is expected with a pneumothorax and is not a cause for immediate concern.
Choice B rationale
Eyelets not being visible indicate that the chest tube is properly placed within the pleural space, not an urgent issue.
Choice C rationale
Movement of the trachea towards the unaffected side is a sign of tension pneumothorax, which requires immediate intervention as it can compromise respiratory function.
Choice D rationale
Crepitus in the area above and surrounding the insertion site indicates subcutaneous emphysema, which can occur but does not necessitate immediate provider notification unless severe.
Correct Answer is D
Explanation
Choice A rationale
Metabolic acidosis is characterized by a low pH and decreased HCO₃ levels, not increased PaCO₂.
Choice B rationale
Metabolic alkalosis presents with an elevated pH and increased HCO₃ levels, which do not match the given values.
Choice C rationale
Respiratory alkalosis is indicated by a high pH and decreased PaCO₂, opposite of the provided values.
Choice D rationale
Respiratory acidosis is identified by a low pH, elevated PaCO₂, and normal HCO₃, aligning with the provided values.