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
Temperature of 36.1°C (97.0°F) is below normal range and not indicative of organ rejection. Organ rejection often presents with elevated temperature due to the inflammatory response of the immune system attacking the transplanted organ.
Choice B rationale
Weight loss is not a common sign of acute organ rejection. Usually, fluid retention and associated weight gain can occur due to decreased kidney function.
Choice C rationale
Oliguria (reduced urine output) is a primary sign of kidney transplant rejection. It indicates that the transplanted kidney is not functioning properly, which is a critical indicator of rejection.
Choice D rationale
Insomnia is not typically associated with organ rejection. It can be related to stress or other factors but is not a direct sign of rejection.
Correct Answer is A
Explanation
Choice A rationale
Agitation is a common manifestation of hypoxemia due to insufficient oxygen reaching the brain and other vital organs.
Choice B rationale
Dysphagia, or difficulty swallowing, is not a typical manifestation of hypoxemia during an asthma attack.
Choice C rationale
Nausea can occur but is not a primary indicator of hypoxemia.
Choice D rationale
Hypotension may occur with severe hypoxemia but is not a direct manifestation of asthma-related hypoxemia.