A kidney transplant client on sirolimus is scheduled for an … | MyMerci
Medical EmergenciesPA
Question
A kidney transplant client on sirolimus is scheduled for an elective inguinal hernia repair. Which is the nurse's most appropriate action?
1No medication change required
2Stop all immunosuppression for 1 month
3Double the sirolimus dose pre-op
4Notify the provider — sirolimus impairs wound healing; many programs hold sirolimus before surgery and bridge with another agent, resuming after wound healing✓ Correct answer
Explanation
Correct (2): Sirolimus (mTOR inhibitor) markedly impairs wound healing and increases dehiscence — most programs hold sirolimus before elective surgery and bridge with another agent (calcineurin inhibitor + MMF) until wound healing. Also causes hyperlipidemia, oral ulcers, proteinuria, interstitial lung disease. (1,3,4) Wrong.
In-depth explanation
Memory Tip mTOR inhibitor (Sirolimus·Everolimus) = "Slows wound healing + Lipids up". Hold around surgery. Used as anti-rejection AND for some cancers.
Clinical scenario
Scenario 55-year-old male 1 year post-kidney transplant on sirolimus; scheduled for elective hernia repair next month.