Medical Surgical Kidney transplant vs Biopsy #3

Question

A nurse receives a client status post-kidney transplantation. Which clinical signs of graft rejection will the nurse monitor? Select all that apply.

Answers

  1. A 2-3 lbs weight gain in 24 hours.
    • Rationale:

      This answer is correct because a weight gain by that much indicates the kidney is not working to remove waste. Therefore, it retains it and this causes weight gain. The body has not recognized the kidney as part of it and is rejecting it.

  2. Edema.
    • Rationale:

      This answer is correct because edema is a result of fluid retention. When the body rejects the graft, the kidney will not work. The kidney will not filter out sodium and water and the body becomes edematous as a result.

  3. Hypertension.
    • Rationale:

      This answer is correct because the kidneys play an important role in regulating blood pressure. As a result of the kidney not performing, waste and volume builds up inside the body. This leads to hypertension.

  4. Pain over grafted kidney.
    • Rationale:

      This answer is correct because pain over a grafted kidney can occur due to many reasons. Infection of the graft or swelling in the area can cause pain. The autoimmune response to the graft can also cause pain.

  5. Bladder distention.
    • Rationale:

      This answer is not correct because bladder distention is not associated with kidney transplant rejection. Causes of bladder distention can be prostate hypertrophy, constipation, or renal calculi.

Overview

Renal graft rejection is the major complication of kidney transplantation. Clinical signs include a 2-3 lb. weight gain in 24 hours, edema, hypertension, pain over the graft, or a fever.

Explanation

Learning Outcomes

Renal graft rejection is the major complication of kidney transplantation. Rejection can occur anywhere from immediately post-transplantation to years afterwards. Clinical signs include a 2-3 lb. weight gain in 24 hours, edema, hypertension, pain over the graft, or a fever. When the kidney is not performing, it cannot filter out waste. Water and sodium will be retained and this will lead to retention. This volume retention will cause weight gain and edema. This will lead to high blood pressure since the heart has to work harder to circulate the greater volume. Pain over the grafted kidney is also a clinical sign of rejection due to the possibility of inflammation, infection, or the autoimmune response.

Test Taking Tip

Know the clinical signs of renal graft rejection.

Video Rationale