Which action is most important for the nurse to teach the client with rheumatoid arthritis who is changing her drug therapy from methotrexate (Rheumatrex) to etanercept (Enbrel)?
A. The need for reliable contraception
B. How to perform subcutaneous injections
C. How to monitor the erythrocyte sedimentation rate
D. The importance of reporting manifestations of infection to the health care provid-er
B
Enbrel is a parenteral medication, whereas Rheumatrex is an oral agent. The client and/or family will need to be taught how to give a subcutaneous injection correctly. Both medications reduce immunity and inflammation, increasing the risk for infection. Methotrexate is known to cause birth defects; however, at this time, the effects of Enbrel on fetal development is unknown. Clients do not self-monitor erythrocyte sedimentation rates.
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