Question

27. A client is exposed to a viral infection. What role will interferon most likely play during this exposure?

a. It will stimulate B-lymphocyte activity.

b. It will interfere with stem cell multiplication.

c. It will stimulate growth of lymphoid cells.

d. It will interfere with virus replication.

28. A client is being administered chemotherapeutic agents for the treatment of cancer. Which blood cells will be stimulated by the colony-stimulating factors in response to the effects of the chemotherapy?

a. White blood cells b. Red blood cells c. Phagocytes d. Myocardial cells

29. A client is receiving epoetin alfa for anemia. Which adjunctive therapy is imperative with epoetin alfa?

a. Potassium supplements b. Sodium restriction c. Iron supplement d. Renal dialysis

30. A 69-year-old female client has been diagnosed with malignant melanoma. The care team has collaborated with the client and her family and agreed on a plan of care that includes administration of interferon alfa-2b. After administering interferon alfa-2b, the oncology nurse should anticipate that the client may develop which adverse effect?

a. Profound diaphoresis b. Decreased level of consciousness c. Flu-like symptoms d. Cyanosis and pallor

Answer 1

27. Answer:-(d) It will interfere with virus replication.

Interferon:-Interferon is a class of glycoproteins which interferes with virus replication. There are numerous types of interferon and each is produced by an animal or by cultured animal cells. Interferon synthesis is induced by viruses or by certain biochemicals and can be of three types:

IFN- a = a - Interferon (20 subtypes) - from many different cell types

IFN - b = b - Interferon (2 subtypes) - from fibroblasts, macrophages

IFN -g = g - Interferon (3 subtypes) - from T-lymphocytes

Characteristics:-

a. Interferons are cell specific in both their production and their effects.

b. Interferons are virus non-specific.

c. Interferons are induced by viruses, chemicals, some species of bacteria and some extracts of fungi.

d. Although all animal cells appear able to produce one or more types of interferon, cells of the bone marrow, spleen, and macrophages, appear to play a special role, i.e., they produce a larger volume of interferon and a more potenti nterferon.

28. Answer :- (a) white blood cells.

Colony-Stimulating Factors::-In the body's bone marrow (the soft, sponge-like material found inside bones) blood cells are produced. There are three major types of blood cells; white blood cells, which fight infection; red blood cells, which carry oxygen to and remove waste products from organs and tissues; and platelets, which enable the blood to clot. Cancer treatments such as chemotherapy and radiation therapy can effect these cells which put a person at risk for developing infections, anemia and bleeding problems. Colony-stimulating factors are substances that stimulate the production of blood cells and promote their ability to function. They do not directly affect tumors but through their role in stimulating blood cells they can be helpful as support of the persons immune system during cancer treatment.

Sargramostim is a growth factor that stimulates the production, maturation and activation of three types of white blood cells (WBC): neutrophils, macrophages and dendritic cells. Each of these three cells has a distinct purpose and function within the immune system. Neutrophils are the most abundant WBC and are the first to responde to the site of an infection. Their purpose is to capture and digest foreign invaders such as bacteria. Macrophages also capture and digest foreign invaders but are longer acting and recognize more invaders than neutrophils. Dendritic cells make up less than 1% of WBC's but are extremely important.

29. Answer :- (c) Iron supplement.

Anemia treatment depends on the cause.

Iron deficiency anemia. Treatment for this form of anemia usually involves taking iron supplements and making changes to your diet.

If the underlying cause of iron deficiency is loss of blood — other than from menstruation — the source of the bleeding must be located and stopped. This may involve surgery.

30. Answer:- (c) flu -like symptoms.

Intron A (Interferon alfa-2b) is an alpha interferon made from human proteins used to treat hairy cell leukemia, malignant melanoma, follicular lymphoma, Kaposi's sarcoma caused by AIDS, certain types of genital warts, and chronic hepatitis B or C. Intron A is often used in combination with another drug called ribavirin (Rebetol).

Common side effects are:-

Flu-like symptoms such as headache, tiredness, fever, chills, and muscle aches and pains may occur, especially when you first start Intron A. These side effects usually last about 1 day after the Intron A injection and improve or go away after a few weeks of continued use.