A client will be starting treatment with the tumor necrosis factor inhibitor, adalimumab (Humira). To begin a new job, the client must receive a tetanus shot because he hasn't received one in 10 years. What should the nurse advise the client?
A) The tetanus shot may be taken at any time without regard to TNF inhibitor drug therapy.
B) The client should receive the tetanus shot prior to beginning TNF inhibitor drug therapy.
C) The client should receive the tetanus shot after beginning TNF inhibitor drug therapy to decrease the complications related to the tetanus.
D) The client should get a note from the physician stating the tetanus shot is not able to be taken by the client.
B
Feedback:
TNF inhibitors decrease the efficacy of vaccines that are T-cell dependent such as those for hepatitis B, viral influenza A and B, human papillomavirus, and tetanus. It is best for clients to receive these types of vaccines before beginning TNF inhibitor drug therapy. Options A, C, and D would be incorrect instructions to give the client.
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