Chapter 17: Immune Modulators

A home care nurse is caring for a client who has received a liver transplant. The nurse is reinforcing earlier teaching about the client's immunosuppressant therapy and the need for appropriate self-care. Which client statement suggests that the client understands?

"I will always be at risk for serious infection."

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 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 respon

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

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."

What client would be most likely to benefit from treatment with filgrastim (Neupogen)?

A client who has recently undergone bone marrow transplant to treat leukemia

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

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

Acute pain related to CNS, GI, and flu-like effects

The home health nurse is to make a home visit to a client that has been discharged from the acute care facility and will be taking mycophenolate at home. What is the priority assessment the home health nurse should make?

Assess the environment for potential sources of infection

7 ____________ is used specifically to help reduce the number of relapses in multiple sclerosis.

Avonex

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

False

What are common nursing diagnoses for a client diagnosed with cancer? (Select all that apply.)

Fatigue

A patient 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

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."

The nurse is teaching a client receiving interferon therapy about measures to combat possible adverse effects. Which statement by the client indicates the need for more teaching?

I need to be out in the sun so that I can get vitamin D."

2 ______________ are used to energize an immune system that needs help fighting a specific pathogen.

Immune stimulants

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

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

3 ______________ are naturally produced and released from human cells in response to a viral invasion.

Interferons

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 who must use long-term immunosuppressant agents is at risk for what complications? (Select all that apply.)

Lymphoma

A client who must use long-term immunosuppressant agents is at risk for what complications? (Select all that apply.)

Lymphoma, Metabolic bone disease,Liver disease

A client with multiple sclerosis is prescribed treatment with a monoclonal antibody. Which action(s) would the nurse add to the client's plan of care? Select all that apply.

Monitor for pulmonary edema.

A client is being treated for malignant melanoma and has been prescribed interferon alfa-2b. The client has complex medical history and the medication regimen includes aspirin, furosemide, bisoprolol and levothyroxine. When planning the client's care, what should the nurse prioritize?

Monitor the client's response to the medication and assess for adverse effects.

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

The nurse is caring for a client who has been prescribed cyclosporine following organ transplant. While teaching the client about the medication, the nurse describes its adverse effects. What would the nurse include in the discussion?

Nephrotoxicity

A client is to receive erlotinib. The nurse would expect to administer this drug by which route?

Oral

5 A monoclonal antibody that is used to help prevent RSV (respiratory syncytial virus) in high-risk children is __________________.

Palivizumab

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

A client is receiving anakinra for treatment of rheumatoid arthritis. The client is scheduled to have arthroscopic evaluation of the right knee. What is the priority nursing diagnosis for this client after the procedure?

Risk for infection

What is an adverse effect of excessive immunosuppression?

Serious infection

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

The importance of keeping the home clean

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.

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

To increase white blood cells

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

A client asks what neutropenia is. Which is the nurse's best response?

a condition when the neutrophil level is very low

9 The immune suppressant used to prevent liver or renal transplant rejection is called ____________.

cyclosporine

Which are common adverse reactions that is included in teaching a client about epoetin? Select all that apply.

fatigue nausea headache

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

history of chronic renal impairment

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 caring for a client following an organ transplant procedure. The client reports that oral cyclosporine tastes awful and that the client is unable to swallow it. The nurse tells the client that it is possible to make the medication more palatable by mixing it with:

orange juice.

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

platelets

Which laboratory values should a nurse monitor for a client prescribed oprelvekin?

platelets

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