Pharmacology Immune Drugs #2

Question

The nurse is providing instructions for a patient prescribed etanercept weekly. Which instruction is most important?

Answers

  1. Take the tablets with food.
    • Rationale:

      This answer is not correct because etanercept is not administered by the PO route. Etanercept is only administered by the subcutaneous route.

  2. Administer medication intramuscularly.
    • Rationale:

      This answer is not correct because etanercept is not administered by the intramuscular route. Etanercept is only administered by the subcutaneous route.

  3. Notify the health care provider of joint stiffness.
    • Rationale:

      This answer is not correct because it is not appropriate to report joint stiffness because etanercept is used to treat symptoms associated with rheumatoid arthritis. Joint stiffness is a primary symptom of rheumatoid arthritis so would not be concerning.

  4. Notify the health care provider of sore throat and fever.
    • Rationale:

      This answer is correct because etanercept is a tumor necrosis factor inhibitor which interferes with the body’s natural immune response to help control autoimmune disease symptoms. Autoimmune diseases etanercept is used to treat include: rheumatoid arthritis, plaque psoriasis, psoriatic arthritis, and ankylosing spondylitis. Etanercept can make the patient immunocompromised, therefore places the patient at risk for being susceptible to infection. The patient should report any sign of infection, including sore throat and fever so the body is not overwhelmed by infection.

Overview

Etanercept is prescribed to treat autoimmune diseases by blocking substances in the immune system. Therefore, the nurse should report symptoms of infection, such as sore throat or fever.

Explanation

The correct answer is D because etanercept affects the immune and inflammatory responses which increases the risk of infection and re-infection of bacterial, fungal, viral, mycobacterial, and parasitic pathogens. Selection A and B are incorrect since the medication is given by the subcutaneous route, not by mouth or intramuscularly. Selection C is incorrect since joint stiffness is found in persons with rheumatoid arthritis.

Learning Outcomes

Etanercept is a tumor necrosis factor inhibitor which interferes with the body’s natural immune response to help control autoimmune disease symptoms. Autoimmune diseases etanercept is used to treat rheumatoid arthritis, plaque psoriasis, psoriatic arthritis, and ankylosing spondylitis. Etanercept can make the patient immunocompromised, therefore places the patient at risk for being susceptible to infection. The patient should report any sign of infection, including sore throat and fever so the body is not overwhelmed by infection.

Test Taking Tip

Many times the correct answer is the longest alternative given, but do not count on it. NCLEX item writers (those who write the questions) are also aware of this and attempt to avoid offering you such “helpful hints.”

Video Rationale