Kidney Transplant Recovery Floor

[kmek30, ASN, BSN, RN]

Hello I have been accepted for a position working at a hospital that has a kidney transplant institute and some of my patient's are going to be medical surgical patients who have had or are going for transplants, I am trying to study up on what all I will need to know so I have some knowledge base, Any ideas besides immunosuppressant's, antirejection meds and post and pre op nursing care for the patient. Just wondering if anyone else has any experience in this field and could give me some advice I am a brand new RN but I have eight years experience working cardiac nursing as a LPN, not much med/surge.

Sincerely,

Interested in Florida

[marienm, RN, CCRN]

Our unit recovers fresh transplants, usually for 2-3 days. Some go right home after that and some move to a med/surg floor. A few thoughts:

1) your orders should include parameters for hourly urine output/when to notify MD and BP parameters. Depending on the pt, our docs want to know if the urine is less than 100mL per hour sometimes...not something I'd even think of with any other pt. A certain amount of permissive HTN is often needed to open up the new kidney...so I've had pts with prn pressors (to keep the SBP>140) but also antihypertensives (to keep it

2) we use IV mycophenolate as part of induction of immunosuppression, which is a hazardous drug & requires special handling. Since we don't usually give 'chemo' drugs on my floor, this is different for us.

3) your pt may be very accustomed to restricting fluids & now needs to learn to be thirsty again!

4) sometmes dialysis is required post-transplant. Not infrequently, we do temporizing measures to bring the potassium down until dialysis in the morning (IV insulin/dextrose/bicarb/calcium; kayexalate PO).

[TheCommuter, BSN, RN]

Moved to our Renal forum for more replies.

[RN58186]

ITNS has a "Core Curriculum for Transplant Nurses" that is an excellent resource. Right now the first edition is on sale for $30 and available on their website.