# A client receiving vedolizumab for ulcerative colitis develops new findings. Which action should the nurse take first?

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=522601&lang=en  
> language: en  
> subject: Adverse Effects/Contraindications/Interactions  
> category: PPT

## Question

A client receiving vedolizumab for ulcerative colitis develops new findings. Which action should the nurse take first?

History

Vitals

Labs

Orders

Notes

Ulcerative colitis treated with vedolizumab; next infusion is scheduled today

Temperature 38.7 C, HR 112/min, BP 102/64 mm Hg, oxygen saturation 93% on room air

ALT 318 units/L, AST 274 units/L, total bilirubin 4.0 mg/dL

(데이터 없음)

(데이터 없음)

1

Administer the next dose and schedule liver testing in 1 year.

✕

2

Hold vedolizumab and obtain urgent evaluation of possible significant liver injury and infection.

✕

3

Add a live vaccine during the febrile illness to improve treatment response.

✕

4

Reassure the client that jaundice and fever are expected markers of remission.

✕

## Explanation

Jaundice with marked transaminase and bilirubin elevation plus fever and respiratory symptoms requires prompt evaluation for significant liver injury and active infection before further vedolizumab exposure.

## In-depth explanation

Quick answer
Act on hepatic injury and active infection before the next biologic dose.

Why this is correct
Vedolizumab should be discontinued for jaundice or other evidence of significant liver injury, and serious infection requires treatment review. Immunization planning does not replace evaluation of an active febrile illness.

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: ENTYVIO (vedolizumab)Serious infection, neurologic monitoring for PML, liver injury, immunization review, and treatment discontinuation

## 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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