Preparation for transplant unit

[m_aidez]

I'm a student and I might be put into a transplant unit this coming semester. I was just wondering what kind of skills will I mostly be exercising (e.g., wound, chest tubes, tracheotomy care)? And what medications should I start reading up on? I've been looking up on the internet but it only names very specific drugs. Also, I'm not sure if the drugs on the net is approved in Canada. I would like to know more about the generic meds or meds that are frequently used in these type of floors.

[NotReady4PrimeTime, RN]

You'll definitely be doing dressing changes. What sorts of transplants does the hospital do? Not too many transplant patients in my experience require tracheostomy unless they've been very ill post-operatively; many of them will have drainage tubes of one sort or another. Renal transplant patients have high fluid requirements to maintain flow of urine through the system. Liver transplant patients experience frequent and dramatic fluid shifts. Multivisceral transplant recipients have weekly biopsies and may also have ileostomy/colostomy. Lung transplant patients may have issues with their transplanted lung(s) twisting on the bronchus since they're only attached there. They have frequent bronchoscopies and biopsies, sometimes daily. Hearts typically go to the CCU then the cardiology ward.

The usually-prescribed drugs for transplant patients would include methylprednisolone, prednisone, tacrolimus, sirolimus, mycophenolate mofetil, rATGAM, ATGAM, azathioprine, furosemide, spironolactone, labetalol, captopril, gancyclovir, fluconazole, nystatin and an assortment of antibiotics.

[m_aidez]

Some of those are immunosuppressant drugs, right?

[m_aidez]

As far as I know this unit has lung, heart, liver and kidney. Thank you for your detailed answer.

[NotReady4PrimeTime, RN]

The immunosuppressants are tacrolimus, sirolimus, mycophenolate, rATGAM, ATGAM, azathioprine and the steroids also provide some immunosuppression as well.

Livers are usually sicker than any of the others, unless the patient was in extremis before the transplant. They're more likely to have had a long ICU stay compared to the others and require lots of blood products on an ongoing basis for the first few weeks.

You'll learn a lot on that unit, and not just about transplants.