# Review the IVIG infusion trend and determine the priority interpretation and response.

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=513953&lang=en  
> language: en  
> subject: Pharmacological Pain Management  
> category: PPT

## Question

Review the IVIG infusion trend and determine the priority interpretation and response.

| Time | Data |
| --- | --- |
| Before infusion | Age 76 years; chronic kidney disease; limited mobility; creatinine 1.4 mg/dL; urine output 45 mL/hr; hydration completed |
| 30 minutes | Minimum prescribed rate; BP 132/74 mm Hg; no symptoms; urine output unchanged |
| 90 minutes | Rate advanced; new right calf pain and swelling; SpO2 decreased from 97 percent to 91 percent |
| 2 hours | Urine output 15 mL/hr; creatinine 1.9 mg/dL; client reports new shortness of breath |

Q1. Which interpretation is the priority?

Expected mild rate-related discomfort only
Possible thrombotic and renal complications during IVIG
Improved renal perfusion from the faster rate

Q2. Which response is appropriate?

Increase the rate to finish the dose sooner
Continue at the same rate and reassess tomorrow
Stop the infusion, assess airway and circulation, notify the authorized team, and initiate urgent evaluation
Give a diuretic without an order and restart immediately

## Explanation

New oliguria, creatinine rise, calf pain, and oxygen decline in a high-risk client require stopping the infusion and urgent evaluation for renal and thrombotic complications.

## In-depth explanation

Quick answer
The trend suggests possible renal dysfunction and thrombosis; stop the infusion and escalate.

Why this is correct
IVIG labels warn of thrombosis and renal failure, especially in predisposed clients. Adequate hydration and the minimum practicable infusion rate are protective, but new renal and thrombotic findings require immediate action.

Easy analogy or mental picture
When kidney and clot warning lights turn on together, do not keep increasing the pump.

Memory hook
IVIG risk: hydrate, go slow, watch kidney and clot signs.

NCLEX decision rule
A tolerated first interval does not guarantee later safety. Respond to the direction of the trend, not only the starting values.

Why the other choices are wrong
Continuing or accelerating the infusion ignores evolving end-organ findings; routine observation alone is insufficient.References
1DailyMed: ASCENIVIVIG thrombosis and renal-risk precautions

## Clinical scenario

IVIG risk trend
Trend infusion rate, hydration, vital signs, renal function, urine output, limb findings, oxygenation, and neurologic symptoms.

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