# A liver transplant client on cyclosporine reports new excessive hair growth, gum overgrowth, and tremor. Which is the nurse's most appropriate response?

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=391873&lang=en  
> language: en  
> subject: Medical Emergencies  
> category: PA

## Question

A liver transplant client on cyclosporine reports new excessive hair growth, gum overgrowth, and tremor. Which is the nurse's most appropriate response?

## Option

1. Discontinue all immunosuppression today
2. These symptoms always require dialysis
3. These symptoms indicate immediate rejection
4. Reassure that these are recognized cyclosporine side effects — emphasize meticulous oral hygiene, monitor BP and renal function, and discuss potential switch to tacrolimus if intolerable **✔ Correct answer**

**Correct answer: 4**

## Explanation

Correct (2): Cyclosporine classic effects: hirsutism, gingival hyperplasia, tremor, hypertension, nephrotoxicity. Oral hygiene with regular dental cleanings reduces gum overgrowth. Switching to tacrolimus (no hirsutism/gum issues) is common if cosmetic effects are intolerable. (1,3,4) Wrong.

## In-depth explanation

Memory Tip Cyclosporine = "Cycle-of-Hair-Gums-Tremor". Tacrolimus = "Diabetes-Neuro-Tox" but no hirsutism. Both nephrotoxic; both CYP3A4.

## Clinical scenario

Scenario 36-year-old female on cyclosporine for liver transplant; new hirsutism, gingival hyperplasia, tremor.

## Key concepts

- **Cyclosporine** — Calcineurin inhibitor; hirsutism, gum hyperplasia, tremor, HTN, nephrotoxicity.
- **Gingival hyperplasia** — Cyclosporine, phenytoin, CCB cause; reduced with diligent oral hygiene.
- **Cyclosporine vs tacrolimus** — Cyclosporine: hirsutism/gum. Tacrolimus: DM/neuropathy. Both: nephrotoxicity.

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