Pharmacology Immune Drugs #3

Question

The nurse is preparing to administer intravenous immunoglobulin (IVIG) to a patient with severe combined immunodeficiency disease (SCID). Which nursing actions will be performed prior to administration of the drug?

Answers

  1. Keep IVIG in the refrigerator and give cold.
    • Rationale:

      This answer is not correct because IVIG should be administered at room temperature, not cold. Immunoglobulin (IG) is an antibody molecule produced by the white blood cells. Intravenous IGi is given to individuals who do not make enough antibodies and have weakened immunity, such as severe immunodeficiency diseases.

  2. Place the patient on NPO status.
    • Rationale:

      This answer is not correct because NPO status is not recommended for administration of IVIG. The patient should be fully hydrated before IVIG administration.

  3. Weigh the patient.
    • Rationale:

      This answer is correct because IVIG is based on the individual’s weight so an accurate weight should be obtained before administration. Changes in weight may indicate a need for dosage increase or reduction. Immunoglobulin (IG) is an antibody molecule produced by the white blood cells. Intravenous IG is given to individuals who do not make enough antibodies and have weakened immunity, such as severe immunodeficiency diseases. Examples of conditions IVIG is administered for include Guillain-Barre syndrome, myasthenia gravis, Kawasaki disease, and immune thrombocytopenia purpura (ITP).

  4. Order IgG peak levels after infusion.
    • Rationale:

      This answer is not correct because IgG trough levels, not peak levels should be drawn prior to administration of IVIG. Monitoring this trough level helps to determine the best interval between doses, since IG clearance varies from person to person. Guidelines suggest the IgG trough just before the next dosage should be at least 500 mg/dL.

Overview

Immunoglobulin (IG) is an antibody and can be given IV to patients needing increased immunity. Intravenou IG is based on the individual’s weight so an accurate weight should be obtained before administration.

Explanation

The correct answer is C. Immunoglobin replacement therapy is prescribed based on weight. Changes in weight may indicate need for dosage increase or reduction. Selection A is incorrect. Although it may be stored in refrigeration, it is NOT administered cold, but at room temperature. Selection B is incorrect since the client needs to be hydrated prior to the infusion. Selection D is incorrect since IgG levels need to be trough levels drawn immediately before the infusion.

Learning Outcomes

Immunoglobulin (IG) is an antibody molecule produced by the white blood cells. Intravenous IG is given to individuals who do not make enough antibodies and have weakened immunity, such as severe immunodeficiency diseases. Examples of conditions IVIG is administered for include Guillain-Barre syndrome, myasthenia gravis, Kawasaki disease, and immune thrombocytopenia purpura (ITP). Intravenou IG is based on the individual’s weight so an accurate weight should be obtained before administration. Changes in weight may indicate a need for dosage increase or reduction.

Test Taking Tip

The nurse should be aware of medications needing peak and trough levels since these medications are very sensitive to dosage changes. These medications can also be high risk for toxicity.

Video Rationale