A kidney transplant recipient taking cyclosporine reports new gum overgrowth and increased facial hair. Which response should the nurse give?
1These findings prove acute rejection, so take an extra cyclosporine dose now.
2These are recognized effects; continue as prescribed, use meticulous oral care, and report for follow-up.✓ Correct answer
3Stop cyclosporine today and begin leftover tacrolimus without transplant-team guidance.
4Ignore the findings because blood pressure and kidney function do not require monitoring.
Explanation
Gum hyperplasia and hirsutism are recognized cyclosporine adverse effects. The client should continue the medication as prescribed, maintain meticulous oral hygiene and dental follow-up, and discuss symptom management with the transplant team. Blood pressure, kidney function, drug exposure, and other toxicities require continued monitoring. The client should not take extra doses, stop immunosuppression, or switch to tacrolimus independently.
Clinical reasoning Cyclosporine can produce gum hyperplasia and increased hair growth while also causing hypertension, tremor, and nephrotoxicity. Cosmetic findings do not by themselves establish rejection or toxicity requiring abrupt withdrawal.
Decision rule Recognize common cyclosporine effects, protect oral health, and maintain transplant-team monitoring; medication changes require coordinated assessment of graft function, kidney function, blood pressure, and drug exposure.
Scenario 36-year-old female on cyclosporine for liver transplant; new hirsutism, gingival hyperplasia, tremor.
Cyclosporine — A calcineurin inhibitor used to prevent transplant rejection that can cause nephrotoxicity, hypertension, tremor, hirsutism, and gum hyperplasia.
Gingival hyperplasia — Overgrowth of gum tissue associated with cyclosporine that is managed with oral hygiene, dental care, and treatment-team review.
Cyclosporine vs tacrolimus — Cyclosporine: hirsutism/gum. Tacrolimus: DM/neuropathy. Both: nephrotoxicity.