Pharm Exam 3 Chapter 17
A 42-year-old client is experiencing chemotherapy-induced thrombocytopenia. The nurse is providing information to the client regarding the medication oprelvekin. Which information would the nurse include in the explanation?
"Chemotherapy has caused you to have a low platelet count, which puts you at risk for bleeding. Oprelvekin is used to increase platelet production to decrease the risk."
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 response?
"The weekly CBC assesses for the development of infection."
The nurse is caring for diverse group of clients. Which client is most likely to benefit from the administration of cyclosprorine?
A client with chronic renal failure who is recovering from a kidney transplant
What are important precautions a nurse should teach a client receiving an immunosuppressant? (Select all that apply.)
Avoid crowds. Keep follow-up appointments for laboratory assessments. Take precautions to avoid getting pregnant
In addition to autoimmune disorders, immunosuppressant medications are used to treat which disorder?
Crohn's disease
Which would the nurse expect to administer orally?
Cyclosporine
While studying the T- and B-cell immune suppressors, the nursing students learn that the most commonly used immune suppressant is
Cyclosporine (Sandimmune).
The nurse is assigned to care for a client who is receiving immune suppressants. The nurse would continually assess the client for which of the following anticipated adverse effects?
Development of cancers Increased risk of infection Development of secondary infections
Most of the drugs that affect the immune system are highly recommended for use in children.
False
A 45-year-old male patient is receiving interferon alfa-2a therapy for hepatitis C. The nurse should teach the patient that he may experience which adverse effect?
Flu-like symptoms
A nurse is caring for a patient who is receiving azathioprine following kidney transplant. For what serious adverse effect should the nurse monitor the patient?
Infection
Which agent would be classified as an immune stimulant?
Interferon alfa-2b
A client is prescribed filgrastim. Which is the nurse's <b>best</b> explanation of how this drug works?
It stimulates growth and production of WBCs to fight off infection.
The nurse educator is teaching an online pharmacology class. The topic of the online seminar is the contraindications for the use of colony stimulation factor. The nurse includes which contraindication?
Known hypersensitivity
Immune suppressants include which classifications of drugs? Select all that apply.
Monoclonal antibodies T- and B-cell suppressors
An adult male client experienced a kidney transplant 2 days ago, and his 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.
To help understand immunostimulant drug therapy, the client has come to the clinic for a class on thrombopoiesis. The nurse explains that the term means the formation of which types of blood cells?
Platelets
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 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 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 male client is diagnosed with severe neutropenia and is prescribed filgrastim. What is the desired effect?
To increase white blood cells
In which situation would the nurse least likely expect to administer an immune suppressant?
Treatment of aggressive cancers
Teaching points that the nurse would incorporate into the care of a client receiving cyclosporine would include which information?
Use barrier contraceptives to avoid pregnancy. Dilute the solution with milk, chocolate milk, or orange juice and drink immediately. Avoid drinking grapefruit juice when on this drug.
A client has a successful liver transplant. The nurse should advise the client prescribed oral cyclosporine to avoid mixing the drug with what form of liquid?
any type of grapefruit juice
Organ transplants are often rejected by the body because the T cells recognize the transplanted cells as foreign and try to destroy them. Treatment with an immune suppressant would
block the initial damage to the transplanted cells.
Which conditions in a client's history should the nurse report to the health care provider who prescribed epoetin alfa? Select all that apply.
congestive heart failure seizures hypertension
Patients who are receiving an immune stimulant may experience any of the clinical signs of immune response activity, including
flu-like symptoms
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 client is taking immunosuppressants. The nurse must assess the client for:
infection
The nurse would expect to administer interferon alfa-n3 (Alferon N) as the drug of choice for
intralesional treatment of warts.
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
Which is the most likely indication for the use of immunosuppressant agents?
organ transplantation
Oprelvekin is a drug that stimulates the process of making which blood cells?
platelets
Patient teaching for a patient receiving an interferon would include
proper methods injecting the drug
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?
the fact that the client is not pregnant
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
Most of the drugs that affect the immune system are not recommended for use in children or have not been tested in children
true
You might use a monoclonal antibody in treating
tumors that overexpress HER2
