Question

A 52-year-old patient with End-Stage Kidney Disease related to alcoholism needs a kidney transplant. The patient’s identical twin sister, who is in good health, has agreed to donate one of her kidneys. Both sisters were admitted to the same hospital for the procedure.

Initial Discussion Post:

Address the following:

What is the RNs role for the kidney recipient in the immediate post-operative period?

What is the RNs role for the kidney donor in the immediate post-operative period?

Are there ethical considerations associated with this kidney donation? Explain.

Should the sister be financially compensated for her donation? Why or why not?

Answer 1

RNs role for the kidney recipient in the immediate post-operative period:
   -Monitor vital signs and hemodynamic pressure closely..
   -diuresis may occur immediately cause hypovolemia,low cardiac output and impaired perfusion of the transplanted kidney..
   -Maintain urinary catheter patency and closed system to keep the bladder decompressed and prevent infection..
   -Measure urine output every half an hour.it will determine fluid balance and transplant function..
   -Maintain fluid replacement for vascular volume and tissue perfusion.
   -administer diuretics as per doctor advice..
   -Remove catheter within 2 to 3 days as per doctor order and encourage patient to void every 1hour and assess patient urinary function for any retension and frequency.
   -Monitor serum electrolytes and renal function test to monitor graft function and electrolyte imbalance..
RNs role for the kidney donor in the immediate post-operative period:
    -Monitor vital signs
   -Provide wound care to prevent infection
   -Monitor fluid level and watch patient for frequency of urine and retention..
   -Prescribe pain medication called vicodin
   -Avoid non-steroidal anti-inflammatory drugs(NSAID) it may damage their kidney..
   -Check serum electrolytes and kidney function test to monitor any electrolyte imbalance.
-Getr followup clinic appointment before patient leave the hospital.
   -Provide education about operation scar it will be permanent after healing..it takes 12weeks for them become normal after the operation.
-Provide psychological support to make their emotions into normal..
Ethical considerations:
   There are three types of donation
   -Direct donation to a loved one or friend
-Non direct donation(general donation)
-directed donation to a stranger(donation for a particular person with no emotional connection)
This donation will come under direct donation to a loved one..here transplantation programe are typically willing to identify a medical excuse,for this case informed consent alone not sufficient,physicians are concern to prevent potentially life-threatening sacrifies unless the chance of success is completely more,major ethical concerns about organ donation by living related donars to a stranger focused on the possiblity of under influence and emotional pressure and coercion..
   Financially compensation between their relationship upto patient choice..As per sister willingness as a brother he can make financial compensation..