# A client receiving teprotumumab for thyroid eye disease returns before the next infusion. Highlight the findings that require prompt medication follow-up.

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=522600&lang=en  
> language: en  
> subject: Adverse Effects/Contraindications/Interactions  
> category: PPT

## Question

A client receiving teprotumumab for thyroid eye disease returns before the next infusion. Highlight the findings that require prompt medication follow-up.

| Domain | Finding |
| --- | --- |
| Glucose | Fasting glucose increased from 108 to 248 mg/dL with polyuria |
| Hearing | New tinnitus and difficulty understanding speech |
| Gastrointestinal | Bloody diarrhea with abdominal cramping and urgency |
| Infusion | Urticaria and blood pressure 86/50 mm Hg during the prior infusion |
| Eye | The client uses prescribed artificial tears |
| Nutrition | The client ate a balanced breakfast |
| Access | The follow-up appointment is scheduled |
| Skin | No rash is present today |

## Explanation

Marked hyperglycemia, new persistent tinnitus or hearing decline, bloody diarrhea with cramping, and an infusion-related hypotensive rash are important teprotumumab safety signals.

## In-depth explanation

Quick answer
Escalate glucose, hearing, bowel, and infusion toxicities.

Why this is correct
Teprotumumab can worsen glycemia, cause severe and sometimes permanent hearing impairment, exacerbate or reveal inflammatory bowel disease, and trigger infusion reactions.

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

Memory hook
Exposure, immune effect, organ toxicity, infection risk, immediate action, and serial reassessment.

NCLEX decision rule
Choose the action that reduces the most immediate medication-related risk while preserving diagnostic evaluation and authorized treatment.

Why the other choices are wrong
Options that continue the exposure, treat only one symptom, or delay reassessment leave the toxic or infectious process active.References
1DailyMed: TEPEZZA (teprotumumab)Hyperglycemia, inflammatory bowel disease, severe or permanent hearing impairment, and infusion reactions

## Clinical scenario

Oncology, transplant, and biologic safety review
Verify the indication, immune status, infection screen, interacting medicines, current organ findings, authorized action, and measurable follow-up.

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