Question

A patient with Crohn’s disease will begin receiving an initial infusion of infliximab [Remicade]. The nurse explains how this drug works to treat this disease. Which statement by the patient indicates a need for further teaching? a. "I may have an increased risk of infections, such as tuberculosis, when taking infliximab."b. "I should report chills, fever, itching, and shortness of breath while receiving the infusion."c. "This drug sometimes provides a complete cure of inflammatory bowel disease."d. "I will take the second dose in 2 weeks, the third dose in 6 weeks, and then a dose every 8 weeks thereafter."

Answer 1

Answer:

Answer is option C.

"This drug sometimes provides a complete cure of inflammatory bowel disease.''

Explanation:

• Crohn’s disease is a type of inflammatory bowel disease (IBD) that is caused by autoimmune or genetic factors. It affects any part of the gastrointestinal tract (from the mouth to the anus) and causes abdominal pain, fever, diarrhea, weight loss, etc.
• There is no known cure for Crohn's disease, but therapies can bring about long-term remission by greatly reducing the symptoms. For patients who have not had success with other medical therapies, Infliximab (Remicade) is used.
• Infliximab is a chimeric monoclonal antibody that binds to and neutralizes a key biologic response mediator called tumor necrosis factor-alpha (TNF-α) on the cell membrane and blocks its activity by destroying TNF-α producing cell, thus decreasing inflammation.
• For Crohn’s Disease, the FDA approved dose for adults is 5 mg/kg IV at 0, 2 and 6 weeks, then every 8 weeks.  
• The common adverse reactions include urinary tract infections, upper respiratory infections and infusion-related reactions such as headache, fevers, chills, abdominal pain, diarrhea, nausea, hives, rash, shortness of breath, hypotension or hypertension, anaphylaxis, pruritus, convulsions, etc.
• Patients treated with infliximab are at increased risk for developing serious infections such as tuberculosis, fungal infections (histoplasmosis, candidiasis, blastomycosis, pneumocystosis, etc), bacterial, viral and other infections due to pathogens like Legionella and Listeria.