Nursing considerations for corticosteroids and immunosuppressants

Nursing considerations for corticosteroids and immunosuppressants ( 3 Questions)

A nurse is evaluating a client who has leukemia and is receiving daclizumab (Zenapax), a monoclonal antibody. What are some of the outcomes that indicate the effectiveness of the therapy?



Correct Answer: D

Daclizumab is a humanized monoclonal antibody that blocks IL-2 binding by recognizing the interleukin-2 receptor α chain (CD25)¹². CD25 is overexpressed in some leukemias, especially human T-cell leukemia virus 1 associated adult T-cell leukemia/lymphoma (ATL)²³. Daclizumab may have an antileukemic effect by reducing the proliferation and survival of leukemic cells that depend on IL-2 for growth¹³. Daclizumab may also induce antibody-dependent cellular cytotoxicity (ADCC) or complement-dependent cytotoxicity (CDC) against leukemic cells that express CD25¹⁴. Daclizumab may reduce the number and size of malignant cells in the blood and bone marrow, which are the main sites of leukemia¹³.

 

The other options are incorrect because:

 

Option A is incorrect because daclizumab does not decrease the frequency and severity of diarrhea, abdominal pain, and rectal bleeding. These are symptoms of ulcerative colitis, a chronic inflammatory bowel disease that affects the colon and rectum. Daclizumab may be used to treat ulcerative colitis by reducing the inflammation and immune-mediated damage to the intestinal mucosa , but this is not its effect in leukemia.

 

Option B is incorrect because daclizumab does not increase appetite, weight gain, energy level, and quality of life. These are general indicators of health and well-being that may be affected by various factors such as nutrition, physical activity, mental health, social support, and environmental conditions. Daclizumab may improve some aspects of quality of life for patients with leukemia by reducing symptoms and complications of the disease¹³, but this is not a specific outcome of its therapy.

 

Option C is incorrect because daclizumab does not normalize stool culture, blood count, electrolytes, and liver function tests. These are laboratory tests that measure different aspects of the body's function and health status. Daclizumab may affect some of these tests by causing side effects such as infection, bone marrow suppression, hepatotoxicity, or electrolyte imbalances¹², but this is not an indication of its effectiveness.




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