A patient is prescribed an immunosuppressive agent. Which statement indicates the patient needs additional instruction from the nurse about this drug?
1. "I should drink a lot of fruit juices, such as grapefruit juice."
2. "I know to call the physician if I start experiencing a lot of bruising."
3. "I should drink plenty of water to keep from getting dehydrated."
4. "If I experience any joint pain, I should take ibuprofen for the pain as needed every 4 hours."
Correct Answer: 1
Immunosuppressive agents inhibit T cell development and activation. They are given concurrently with glucocorticoids and in combination with other immunosuppressants, and inhibit immune system activity and organ rejection. Nursing responsibilities include monitoring blood urea nitrogen levels and creatinine for evidence of nephrotoxicity. The patient should avoid grapefruit juice, which can raise cyclosporine levels by 50% to 200% and increase the risk of toxicity. Fluids should be increased to maintain good hydration and urinary output. Ibuprofen is acceptable for immunosuppressive medications, but should not be taken with cytotoxic agents. The physician should be notified about any bruising.
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