Introduction
Kidney Transplant is a complex procedure, wherein a healthy kidney from a living or deceased donor is surgically implanted into the body for replacing a damaged/diseased kidney of a patient. Nursing care plan for Post Kidney Transplantation is focused on effective management of complications like rejection and infection to optimise patient outcomes.
Assessment
To ensure that the patient is in good condition post operation, nurses should conduct frequent assessment to monitor signs and relieve symptoms of organ rejection, signs of infection and other intensive care needs. Assessment parameters include:
- Vital Signs - monitoring fluctuations in temperature, heart rate, respiratory rate, and blood pressure on a regular basis.
- Laboratory Values - evaluating hemoglobin, electrolyte level, serum creatinine, etc. from samples like blood, urine, etc.
- Infection - history of previous infections and current signs of infection can be monitored through laboratory values as well as physical examinations.
- Rejection - observing for any changes like tenderness, increasing swelling, fever and discolouration of new transplanted kidney.
- Hypertension - regular readings of diastolic and systolic bp levels and determining the cause if they both are elevated.
- Pain - evaluating the amount of pain experienced by the pt, adjustment of analgesic and any reflex actions.
- Medication - noting the response of medication to prevent organ rejection such as basiliximab, mycophenolate mofetil, tacrolimus, etc.
Nursing Diagnosis
- Risk for Infection - Due to replacement of body organs, the patient has a higher susceptibility to infection.
- Ineffective Airway Clearance - Due to accumulation of secretions or mucus, the patient is at risk of ineffective airway clearance resulting in poor oxygenation.
- Risk of Injury - Due to increased nervousness, confusion and drowsiness, the patient is at risk of tissue damage like skin breakdown.
- Risk for Fluid Volume Deficit - With excretion of more fluid than usual, there is a risk of dehydration.
Outcome
- The patient is able to remain free from infection,
- The patient is able to maintain adequate airway clearance,
- The patient is safe from injury,
- The patient's fluid volume is within the normal range,
- The patient expresses satisfaction with care received.
Interventions
- Assist the patient in maintaining proper hygiene including frequent hand washing.
- Encourage the patient to take adequate rest periods and perform light exercises as instructed.
- Administer antibiotics as prescribed to prevent infection.
- Administer immunosuppressants to stop the body's rejection of the transplanted organ.
- Monitor vital signs, laboratory values and observe for sign of infection routinely.
- Ensure that the patient follows the prescribed diet and adequate intake of fluids.
Rationales
- Proper hygiene helps to create an environment to avoid infection
- Rest and exercises aid in better healing and improve patient's outcome.
- Antibiotics act as medications which helps in protecting the patient from any infection.
- Immunosuppressants help to prevent organ rejection, having little or no effect on the body's ability to fight infection
- Monitoring helps in assessing patient condition immediately and to provide speedy medical aid.
- Adequate fluid and dietary intake ensures nourishment to the transplanted organ.
Evaluation
The effectiveness of the care plan should be evaluated within 24 hrs, and on subsequent days. Evaluation parameters include:
- Due to a decrease or absence of signs or symptoms of infection or organ rejection
- Improved airway clearance
- Normal BP and electrolyte levels
- Increased sense of wellbeing/satisfaction
Conclusion
Nursing interventions after post kidney transplantation aim at optimising patient outcomes by preventing complications such as infection and organ rejection. It is essential for nurses to focus on preventive care, early detection and prompt treatment for the best possible prognosis.
FAQs
- what is kidney transplantation?
Kidney Transplantation is a complex procedure wherein a healthy kidney from a living or deceased donor is surgically implanted into the body for replacing a damaged/diseased kidney of a patient. - how does infection affect a transplant patient?
A transplant patient suffering from infection can experience fever, abdominal pain, swelling and redness around the transplant site, fatigue, loss of appetite and decreased urine output. - What is the risk of organ rejection?
The major risk of organ transplantation is organ rejection which implies that the body rejects its own organ. If left untreated, it may lead to serious life-threatening conditions. - What is the role of nurse in caring for transplant patients?
Nurses play an important role in planning, coordinating, implementing and evaluating nursing plans for transplant patients to ensure that the patient receives excellent treatment and care. - How to take care of a transplant patient?
A transplant patient needs to follow regularly scheduled checkups and tests, maintain proper hygiene, eat a healthy balanced diet, get ample rest, exercise and stay away from people who have infectious diseases.
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