Module 9 Prep U: Immunity

The nurse is caring for diverse group of clients. Which client is most likely to benefit from the administration of cyclosporine?

A client with chronic renal failure who is recovering from a kidney transplant

A client with rheumatoid arthritis has been receiving various drug therapies for treatment but with little effect. What might the nurse expect to be used?

Abatacept

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

Which statement indicates that the client understands immunosuppressant therapy following a solid organ transplant?

I know that I will need to stay on this medication for the rest of my life."

A nurse is teaching about filgrastim to a client. During the teach-back session, which statement by the client indicates a need for additional teaching?

I will take this medication until it is all gone

Which are examples of adverse effects of immune suppressants? Select all that apply

Increased risk for infection Hepatotoxicity Renal toxicity Pulmonary edema

Which agent would be classified as an immune stimulant?

Interferon alfa-2b

Immune stimulants include which classification of drugs? Select all that apply.

Interferons Interleukins

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

Nephrotoxicity

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

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

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

RBC

Six months after undergoing transplantation, a female client asks her health care provider if it would be all right for her to volunteer at the local children's health clinic. She has limited adverse effects from her immunosuppressant drugs and is beginning to feel healthy again. The provider suggests alternate volunteer options because:

She may develop an infectious process at the clinic.

A client is receiving an IV immune stimulant and develops a cardiac arrhythmia. What is the nurse's priority action?

Stop the drug immediately.

A female client is prescribed cyclosporine after her bone marrow transplant. What is the mechanism of action of cyclosporine that makes this an ideal drug for this patient?

Suppression of the normal effects of the immune system in the body

A client is undergoing chemotherapy for vulvar cancer. The client had a friend who died after treatment, which has caused severe anxiety and fear; the client is constantly tired and sees this as an indication she won't survive. The nurse knows that the client is scheduled for immunostimulant drug therapy to support the hematopoietic system. The nurse would include which statement to explain the action of drug?

Taking immunostimulants to stimulate the production of blood cells will help you feel better.

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 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

A male client is diagnosed with severe neutropenia and is prescribed filgrastim. What is the desired effect?

To increase white blood cells

The client has arrived in the short stay unit for an infusion of tositumomab with 131 tositumomab. Before beginning the infusion, the nurse assesses the client's vital signs and finds the client has a temperature of 101.5°F (38.6°C). What is the nurse's best action?

Treat the fever as ordered before beginning the therapy.

The nurse has administered a client's prescribed daily dose of filgrastim. When assessing for a therapeutic effect, what laboratory finding should the nurse prioritize?

White cell differential

The health care provider is planning to prescribe mycophenolate mofetil for a 28-year-old woman. The nurse understands that before receiving this prescription, the client is required to have:

a negative pregnancy test.

The nurse is writing a plan of care for a client receiving immune suppressants for leukemia. What would be an appropriate nursing diagnosis for this client?

acute pain related to gastrointestinal (GI) and flu-like effects

Most of the drugs that affect the immune system are highly recommended for use in children.

false

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 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

The nurse closely monitors a client who is receiving anakinra and etanercept for:

severe infection

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

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

the importance of a clean home

What common adverse reactions of tacrolimus should the nurse teach the client? (Select all that apply.)

tremors hair growth gum hyperplasia