1. No, because J.L has a fever which means she has an infection and her roommate is still
not 100% back to normal in terms of his wbc count. J.L. is also immunocompromised.
2. Infection and organ rejection
3. Tacrolimus is used alongside other medications to prevent organ rejection and she is
post cardiac transplantation. If J.L is receiving medication to prevent organ rejection than
we must determine why she is experiencing a fever.
4. Transplant rejection: chills, fever, nausea, cough, shortness of breath, general
discomfort, pain and swelling around the organ.
Sepsis: fever, hypotension, tachycardia, confusion, shortness of breath, and clammy or
sweaty skin.
J.L. Is experiencing both tachycardia and fever. Her RR is borderline at 20 and her blood
pressure is slightly elevated at 130/78.
5. Painful urination can be a possible side effect of the Zaroxolyn and it can also be an
indicator of a UTI. A urinalysis and urine culture should be obtained.
6. J.L’s urinalysis shows an increased WBC count, nitrate positive and bacterial colonies
which is indicative of a UTI.
7. Primary nursing concern would be if there are any other infections going on besides a
UTI since J.L. is immunocompromised.
8. Standard precautions, intake and output, limit visitors, fluids and antibiotics
9. UTI will resolve with the completion of antibiotics, fever will resolve and wbc count will
go back to normal.
10. J.L.’s urine culture and sensitivity results show that she is positive for Staph Aureus and
the only two medications that are not resistant to the bacteria are Doxycycline and
Vancomycin.
11. J.L. needs to be started on antibiotics to treat the infection
12. J.L. needs to be placed on contact precautions for her MRSA which includes wearing
gloves and a gown when coming into contact with J.L.
13. Vancomycin can only be run with normal saline. It also needs to be run slow since it can
cause tissue necrosis and extravasation due to its corrosive nature. Peak and troughs
also need to be done to check the drug levels in the body.
14. A, C and E
15. Since J.L. is immunosuppressed, her husband needs to make sure that J.L. does not go
near the kitty litter since she is susceptible to getting toxoplasmosis.
16. Avoid contact with anyone who is sick, hand hygiene, avoid large crowds, drink safe
water, avoid touching animals, make sure food is completely cooked and fruits and
veggies are washed thoroughly,
17. Signs of infections can include: fever, chills, sore throat, fatigue, body aches, shortness of
breath, cough, diarrhea, vomiting and nausea
Report to the doctor if you have a fever of 101 or greater – a fever is usually the best
indicator of an infection in immunocompromised patients since sometimes the other
signs don’t show (https://www.stjude.org/treatment/patient-resources/caregiver-
resources/infection-tips/infections-immunocompromised-patients.html)
18. C
