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Preoperative preparation for a child in renal failure presenting for transplant should include all of the following EXCEPT:

a) Cardiac evaluation for volume overload and/or LVH on echocardiogram or EKG

b) The administration of enteral potassium-binding resins for a patient with a serum potassium of 6.0 mMol/L or greater

c) Laboratory evaluation for EBV infection, BK virus infection, serum electrolytes, and blood type and cross

d) Consideration of the nature of the graft, whether cadaveric or living donor

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Answer

Answer b. A patient with a serum potassium of 6.0 mMol/L or greater about to undergo surgery should be considered for preoperative dialysis rather than resin therapy. Cadaveric grafted procedures are more likely to be urgent in nature and may influence the level of preparedness of the recipient, including NPO status and preoperative optimization.

Notes

This question originally printed in the Pediatric Anesthesiology Review Topics kindle book series, and appears courtesy of Naerthwyn Press, LLC.

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