A client undergoing treatment for rheumatoid arthritis is administered etanercept (Enbrel). What should the nurse prioritize assessing?

When a client is being treated with etanercept (Enbrel), which is a biologic response modifier used primarily for autoimmune conditions like rheumatoid arthritis, prioritizing the assessment of white blood cell counts and platelet counts is crucial. Etanercept functions by inhibiting tumor necrosis factor (TNF), which helps reduce inflammation but can also impact the immune system and bone marrow function.

Monitoring white blood cell counts is particularly important due to the risk of immunosuppression associated with TNF inhibitors. These medications can increase the client's susceptibility to infections because they diminish the body’s inflammatory response. Additionally, assessing platelet counts is important due to the potential for developing thrombocytopenia, a condition where the number of platelets is abnormally low, which can affect bleeding and clotting.

While assessing the injection site for itching and edema, monitoring fatigue and joint pain, and identifying symptoms like a metallic taste in the mouth or anorexia are certainly relevant, they are secondary to the more critical need for monitoring the hematologic parameters in this context. The risk of significant changes in the immune response and blood cell production necessitates prioritizing laboratory values related to white blood cell and platelet counts to ensure the client's safety and to manage any complications proactively.