Nursing Diagnosis for Renal Transplantation

Kidney transplantation or renal transplantation is the organ transplant of a kidney into a patient with end-stage renal disease. Kidney transplantation is typically classified as deceased-donor (formerly known as cadaveric) or living-donor transplantation depending on the source of the donor organ. Living-donor renal transplants are further characterized as genetically related (living-related) or non-related (living-unrelated) transplants, depending on whether a biological relationship exists between the donor and recipient.


Nursing Diagnosis for Renal Transplantation

1. Risk for infection related to altered immune system secondary to immunosuppressant medications

2. Risk for altered oral mucous membrane related to increased susceptibility to infection secondary to immunosuppression.

3. Risk for self-concept disturbance related to transplant experience, potential for rejection, and side effects of medications.

Kidney Transplant Medical Treatment

Kidney Transplant Medical Treatment

The most critical part of kidney transplantation is preventing rejection of the graft kidney.

• Different transplant centers use different drug combinations to fight rejection of a transplanted kidney.
• The drugs work by suppressing your immune system, which is programmed to reject anything "foreign," such as a new organ.
• Like any medication, these drugs can have unpleasant side effects.
• Some of the most common immune-suppressing drugs used in transplantation are described here.
  • Cyclosporine: This drug interferes with communication between the T cells of the immune system. It is started immediately after the transplant to suppress your immune system and continued indefinitely. Common side effects include tremor, high blood pressure, and kidney damage. These side effects are usually related to the dose and can often be reversed with proper dosing.
  • Corticosteroids: These drugs block T-cell communication as well. They are usually given at high doses for a short period immediately after the transplant and again if rejection is suspected. Corticosteroids have many different side effects, including easy bruising of the skin, osteoporosis, avascular necrosis (bone death), high blood pressure, high blood sugar, stomach ulcers, weight gain, acne, mood swings, and a round face. Because of these side effects, many transplant centers are trying to reduce the maintenance dose of the drug as much as possible or even to replace it with other drugs.
  • Azathioprine: This drug slows the production of T cells in the immune system.Azathioprine isusually used for long-term maintenance of immunosuppression. The most common side effects of this drug are suppression of the bone marrow, which produces blood cells, and liver damage. Many transplant centers are now using a newer drug called mycophenolate mofetil instead of azathioprine.
  • Newer antirejection drugs include tacrolimus, sirolimus, and mizoribin, among others. These drugs are now being used to try to reduce side effects and to replace drugs after episodes of rejection.
  • Other costly and experimental treatments include using antibodies to attack specific parts of the immune system to decrease its response.

Signs and Symptoms of Testicular Torsion

In the fetus the testicle develops within the abdomen and migrates down into the scrotum, trailing its blood supply behind it like a leash. In the scrotum the testicle resides within a smooth sack called the tunica vaginalis. The testicle can spin and move about within the sack. As males grow and age the testicle develops connections with the sack making it harder for the testicle to spin or twist. This is why torsion is usually seen in younger men, adolescents, and children.

It can occur during fetal development leading to neonatal torsion or vanishing testis and is one of the main cause for monarchism (single testicle).

It needs emergency treatment to save the testicles. Other wise it can lead to permanent damage to the testicles leading to necrosis of testis and atrophy of testis. It can lead to sterility

Signs and symptoms of testicular torsion

• Severe sudden pain in the scrotum.
• Swelling of the scrotum.
• Redness of skin of the scrotum.
• Lower abdominal pain.
• Fever.
• Testicle is positioned at an higher level than normal or at an odd angle.