A client is being discharged home on oral steroids post kidney transplant. Which of the following side effects is of most concern?

Choice A reason: Irritability from steroids results from their impact on the central nervous system, altering neurotransmitter activity like serotonin, leading to mood changes. While bothersome, it poses less immediate risk to the transplanted kidney compared to cardiovascular complications, as it does not directly impair graft function or systemic health in the short term. Choice B reason: Headaches may occur due to steroids causing vascular changes or fluid retention, increasing intracranial pressure. Though uncomfortable, they are typically manageable with analgesics and less critical than hypertension, which directly threatens the kidney graft and cardiovascular system, making them a lower priority in post-transplant monitoring. Choice C reason: Weight loss is not a typical steroid side effect; steroids usually cause weight gain via increased appetite and fluid retention. In post-transplant clients, weight loss might suggest rejection or malnutrition but is less urgent than hypertension, which can damage the graft through elevated vascular pressure and reduced renal perfusion. Choice D reason: High blood pressure, a common steroid side effect, results from sodium retention and vasoconstriction, increasing cardiovascular strain and risking graft damage. In post-transplant clients, uncontrolled hypertension can lead to renal artery stenosis or graft dysfunction, making it the most concerning due to its direct impact on kidney health and systemic stability.