PrepU-Chapter: 17

The nurse is preparing to administer oprelvekin to a client diagnosed with a chemotherapy-induced bleeding disorder. The nurse is explaining to the client the reason for administering this drug? Which explanation is best?

"The drug is used to increase platelet count during chemotherapy."

A nurse is precepting a nursing student, and together they are caring for a patient who is to receive interleukins. The student nurse asks what happens physiologically when a patient receives interleukins. What would be the nurse's best response?

"The patient has increases in the number of natural killer cells."

A client is administered mycophenolate to prevent rejection of the transplanted heart. It is recommended that the client have a CBC drawn weekly. The client asks the nurse the reason for the weekly CBC. What is the nurse's best response?

"The weekly CBC assesses for the development of infection."

The nurse is administering colony-stimulating factors to an older adult client after chemotherapy. The nurse should explain to the client that this medication is being administered for which reason?

"Your body is going to have trouble fighting off infections on it's own. This medication will help with that."

While studying the T- and B-cell immune suppressors, the nursing students learn that the most commonly used immune suppressant is:

Cyclosporine

A client is receiving omalizumab to treat allergic asthma, which is not relieved by inhaled corticosteroids. Which nursing intervention is appropriate with each dose administration of omalizumab?

Have epinephrine available during administration.

A group of students are reviewing information about immune modulators in preparation for a test. The students demonstrate understanding of the material when they identify what as an immune stimulant?

Interferon

After teaching a group of students about immune modulators, the instructor determines that additional teaching is needed when the students identify what as an immune suppressant?

Interferon alfa-2b

A client diagnosed with anemia asks what the cause of anemia is. Which is the nurse's best response?

It is caused by a decrease in the number of RBCs.

A client is prescribed filgrastim. Which is the nurse's best explanation of how this drug works?

It stimulates growth and production of WBCs to fight off infection.

A 34-year-old man is prescribed interferon alfa-2a for the treatment of chronic hepatitis C. When teaching John about the medication, which side effect will the nurse explain is among the most common?

Nausea and changes in taste

A client is administered cyclosporine to prevent rejection of a kidney transplant. Which is a major adverse effect of cyclosporine?

Nephrotoxicity

Which is the most likely indication for the use of immunosuppressant agents?

Organ transplantation

An adult client experienced a kidney transplant 2 days ago, and the regimen of antirejection drugs began just prior to surgery. What nursing action should be integrated into this client's plan of care?

Place the client in a single, protective isolation room.

A patient who is receiving an immune modulator has been admitted to the unit. What would be a priority action by the nurse?

Protect the patient from exposure to infection.

The nurse is reviewing laboratory values of client who has a respiratory illness. Which cells supply oxygen to the tissues?

RBCs

What is an adverse effect of excessive immunosuppression?

Serious infection

(TRUE/FALSE) Most of the drugs that affect the immune system are not recommended for use in children or have not been tested in children.

TRUE

A client is receiving immunosuppressant therapy. Which adverse effects should the client be educated about regarding these effects?

The importance of keeping the home clean

A hospital patient began treatment with interferon alfa-2a several days ago and the care team is pleased with the patient's response at this point in treatment. However, the patient has stated to the nurse that he feels increasingly despondent and claims to have lost all hope of recovering from his disease, despite being an optimistic person. How should the nurse best interpret the patient's statements?

The patient may be having psychological adverse effects of interferon alfa-2a.

A patient has been newly diagnosed with malignant melanoma. The patient is taking phenytoin for a seizure disorder, and Intron-A has been prescribed. What is the nurse aware will probably occur?

The phenytoin dose will be decreased.

While studying for a pharmacology test, a student asks peers about interferons. What statement about interferons is true?

They interfere with the ability of viruses in infected cells to replicate.

The nurse is discussing adverse reactions involving the cardiovascular system after administration of oprelvekin. The nurse would include which reactions in the client teaching plan?

arrhythmia

Which would the nurse expect to administer orally?

cyclosporine

Which adverse reactions should the nurse discuss with a client prior to the administration of oprelvekin ? (Select all that apply.)

fever fluid retention syncope

What client assessment finding will have the greatest effect on the half-life of methotrexate therapy?

history of chronic renal impairment

Use caution and arrange to reduce the dose if a monoclonal antibody is combined with any other ________________ drug because severe immune suppression with increased infections and neoplasms can occur.

immunosuppressant

A 53-year-old man is receiving cyclosporine in order to prevent rejection of a transplanted kidney. The nurse should prioritize assessments related to:

infection

A 78-year-old male client begins an immunosuppressant therapy for his rheumatoid arthritis. The nurse is concerned because this client is at greater risk for what complication, compared with younger adults using the same treatment modality?

infections

A nurse is providing patient education to a 45-year-old man who is taking cyclosporine (Sandimmune). The nurse will provide the patient with education related to one of the most common and severe adverse effects of cyclosporine, which is:

nephrotoxicity.

A nurse is reviewing the laboratory values of a client admitted for gastrointestinal bleed. Which cells control bleeding?

platelets

Oprelvekin is a drug that stimulates the process of making which blood cells?

platelets

Mycophenolate mofetil is being considered in the treatment of a 39-year-old female transplant recipient. Before the initiation of therapy, the nurse must assess the client for what information to ensure safety?

pregnancy status

The nurse is caring for a child who will be receiving a renal transplant and who has been prescribed cyclosporine. When teaching the parents and child about this drug, the nurse should explain what primary rationale for administering this drug?

prevention of organ rejection

Which conditions in a client's history should the nurse report to the health care provider who prescribed epoetin alfa? Select all that apply.

seizures congestive heart failure heart failure

The nurse is caring for a client who has been prescribed mycophenolate mofetil following kidney transplant. What instruction should the nurse provide during client teaching to minimize the risk of undesired effects?

taking the pills on an empty stomach