Chapter 51: Immune Modulating Therapies Introductory Clinical Pharmacology 12th Edition by Susan M Ford

Introductory Clinical Pharmacology 12th Edition by Susan M Ford 1. The nurse caring for a client who is receiving treatment for cancer. The client has been informed that they will be receiving a drug to support passive immunity. When the client asks the nurse to explain passive immunity, how will the nurse respond? a. “It involves administration of antibodies from another person or animal.” b. “Passive immunity is based on previous exposure to an antigen.” c. “It involves your body’s ability to recognize antigens as different from your own cells.” d. “It is the form of immunity provided by vaccines.” Answer: A Rationale: Passive immunity results from the administration of ready-made antibodies from another individual or animal. It creates no memory to protect against a later infection, so therapies must be repeated for sustained protection. Active immunity is based on exposure to antigens. The immune system regards them as foreign and over time develops the ability to recognize and attack them. Vaccines provide active immunity to disease. Question format: Multiple Choice Chapter: 51 Learning Objective: 1 Cognitive Level: Apply Client Needs: Physiological Integrity: Pharmacological Therapies Integrated Process: Clinical Problem-solving Process (Nursing Process) Reference: p. 699, Agents That Support Passive Immunity 2. A client asks the nurse to explain how cancer cells grow. What term should the nurse use to describe the process by which cancer cells develop their own blood vessels? a. Metastasis b. Angiogenesis c. Allogeneic d. Cytotoxic Answer: B Rationale: Angiogenesis occurs when the cancer cells that have invaded the body grow their own blood vessels. Metastasis is the development of secondary malignant growths at a distance from a primary site of cancer. Allogeneic refers to items derived from an external source; in the context of cancer vaccines, the term describes vaccines derived from cells other than the client’s. The term cytotoxic indicates toxicity to living cells. Question format: Multiple Choice Chapter: 51 Learning Objective: 1 Cognitive Level: Understand Client Needs: Physiological Integrity: Pharmacological Therapies Integrated Process: Clinical Problem-solving Process (Nursing Process) Reference: p. 698, Key Terms 3. A health care provider (HCP) is considering medication therapy for a client with a large cancerous tumor. If the HCP is considering a drug that supports passive immunity, what type of drug is under consideration? Select all that apply. a. Monoclonal antibody b. Tumor-associated antigen c. Checkpoint inhibitor d. Cancer vaccine e. Interferon Answer: A, C, E Rationale: Monoclonal antibodies—including checkpoint inhibitors—and cytokines—a class that includes interferons—work by passive immunity. The therapies must be repeated for ongoing protection from the foreign invader. A cancer vaccine supports active immunity. A tumor-associated antigen is not a drug. Instead, it is a protein found on or within tumor cells. Question format: Multiple Select Chapter: 51 Learning Objective: 2 Cognitive Level: Apply Client Needs: Physiological Integrity: Pharmacological Therapies Integrated Process: Clinical Problem-solving Process (Nursing Process) Reference: p. 699, Agents That Support Passive Immunity 4. A client is to receive interferon-alpha for the treatment of lymphoma. Which generalized symptoms should the nurse suspect and assess for during the administration of this medication? Select all that apply. a. Chills b. Muscle aches c. Edema d. Diarrhea e. Headaches f. Malaise Answer: A, B, D, E, F Rationale: Interferons have cytotoxic properties. Like all cytokines, they create an immune response that can be flu-like symptoms. These include chills, cough, fever, headache, and malaise. Other symptoms include nausea, muscle aches, fatigue, sore throat, reduced appetite, or diarrhea. Skin rashes, injection pain and inflammation, edema in the extremities, and antibody development can occur. Question format: Multiple Select Chapter: 51 Learning Objective: 2 Cognitive Level: Apply Client Needs: Physiological Integrity: Pharmacological Therapies Integrated Process: Clinical Problem-solving Process (Nursing Process) Reference: p. 699, Cytokines 5. A nurse is preparing to administer aldesleukin. The health care provider has ordered a full set of vital signs before the administration, after 20 minutes of infusion, and at the completion of the infusion. Which statement best supports the vital sign assessment? a. The heart rate will indicate a transfusion reaction. b. A change in blood pressure may indicate capillary leak syndrome. c. The respiratory rate will monitor oxygen and carbon dioxide exchange. d. Changes in temperature will signal an allergic reaction. Answer: B Rationale: Administration of cytokines such as aldesleukin (an interleukin) results in increased vascular permeability. This can result in capillary leak syndrome, in which fluid leaks out of the circulation an into surrounding tissues, causing edema and dangerously low blood flow. Monitoring the vital signs helps identify the presence of capillary leak syndrome. Low blood pressure is the first clinical sign, and heart rate and respiratory rate would increase as the body attempts to correct the low blood pressure. Question format: Multiple Choice Chapter: 51 Learning Objective: 3 Cognitive Level: Apply Client Needs: Physiological Integrity: Pharmacological Therapies Integrated Process: Clinical Problem-solving Process (Nursing Process) Reference: p. 699, Cytokines 6. A nurse is preparing to administer interferon alfa-2b to a client being treated for renal cell carcinoma. Which condition in the client’s history would this medication be used cautiously? a. Seizure disorder b. Osteoarthritis c. Endometriosis d. Attention deficit disorder (ADD)