# A client taking nintedanib for progressive fibrosing lung disease develops new findings. Which action should the nurse take first?

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=522579&lang=en  
> language: en  
> subject: Adverse Effects/Contraindications/Interactions  
> category: PPT

## Question

A client taking nintedanib for progressive fibrosing lung disease develops new findings. Which action should the nurse take first?

History

Vitals

Labs

Orders

Notes

Progressive fibrosing interstitial lung disease treated with nintedanib

BP 92/56 mm Hg, HR 114/min, respirations 22/min

ALT 286 units/L, AST 241 units/L, total bilirubin 3.1 mg/dL, creatinine 1.5 mg/dL from 0.9 mg/dL

(데이터 없음)

(데이터 없음)

1

Continue nintedanib and wait for the next annual liver panel before reporting symptoms.

✕

2

Hold nintedanib and obtain urgent evaluation of possible drug-induced liver injury and dehydration.

✕

3

Double the next dose to replace medication lost during episodes of diarrhea.

✕

4

Restrict fluids and add an over-the-counter antidiarrheal without treatment-team review.

✕

## Explanation

Persistent diarrhea with poor intake plus jaundice, dark urine, and markedly elevated liver tests suggests serious nintedanib toxicity requiring interruption and urgent evaluation.

## In-depth explanation

Quick answer
Act on hepatic injury plus gastrointestinal volume loss.

Why this is correct
Nintedanib can cause drug-induced liver injury and significant diarrhea. Symptoms and laboratory changes require prompt assessment rather than continued exposure.

Easy analogy or mental picture
Use a closed medication-safety loop: identify the exposure, connect the new findings, interrupt further harm, support physiology, and verify the response over time.

Memory hook
Exposure, interaction, toxicity pattern, immediate action, serial reassessment.

NCLEX decision rule
Choose the action that reduces the most immediate medication-related risk while preserving monitoring and escalation.

Why the other choices are wrong
Options that continue the exposure, treat only one symptom, or delay reassessment leave the toxic process active.References
1DailyMed: OFEV (nintedanib)Drug-induced liver injury, gastrointestinal adverse effects, bleeding risk, and treatment interruption

## Clinical scenario

Medication safety review
Verify the indication, route, interacting medicines, current respiratory and gastrointestinal findings, authorized action, and measurable follow-up.

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