Nokea
A 45-year-old patient with TB is to receive rifampin. The nurse would monitor the patient for which of the following?
- A. Diarrhea
- B. Fever
- C. Dermatitis
- D. Vertigo
Correct Answer: D
Rationale: The nurse should monitor for vertigo as an adverse reaction of rifampin in the patient. Diarrhea, fever, and dermatitis are not adverse reactions of administering rifampin. Diarrhea is an adverse reaction of pyrazinamide. Fever is an adverse reaction of isoniazid. Dermatitis and pruritus are the adverse reactions of ethambutol.
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A client is entering the continuation phase of treatment for tuberculosis. Which of the following would the nurse expect the client to receive? Select all that apply.
- A. Isoniazid
- B. Rifampin
- C. Ciprofloxacin
- D. Pyrazinamide
- E. Ethambutol
Correct Answer: A,B
Rationale: The continuation phase includes only the drugs isoniazid and rifampin.
A patient diagnosed with TB is undergoing treatment. The nurse knows that which of the following would be used for household members and other close associates of the client to help prevent the spread of the disease?
- A. Long-term therapy
- B. Prophylactic therapy
- C. DOT therapy
- D. Short-term therapy
Correct Answer: B
Rationale: Prophylactic therapy will prevent or avoid the spreading of TB in household members and other close associates of the diagnosed client. Long-term treatment does not prevent the spreading of TB, though it may eventually cure or reduce the intensity of the disease. Directly observed therapy (DOT) is used to administer drugs two to three times weekly. Using DOT will not prevent the TB from spreading. Usually, short-term therapy is of no value in treating TB. Short-term therapy will also not prevent the disease from spreading.
When providing care to a client taking isoniazid (INH), the nurse would monitor the client carefully for which of the following that indicate toxicity? Select all that apply.
- A. Peripheral neuropathy
- B. Visual changes
- C. Nausea
- D. Vomiting
- E. Hepatitis
Correct Answer: A,E
Rationale: Signs of isoniazid (INH) toxicity include peripheral neuropathy and hepatitis.
A 72-year-old patient with TB is undergoing standard treatment in a health care facility. Which ongoing assessment would the nurse complete?
- A. Monitoring for appearance of adverse reactions
- B. Monitoring patient's vital signs every 24 hours
- C. Assessing patient's history of contacts
- D. Use DOT to administer the drug to the patient
Correct Answer: A
Rationale: The nurse should monitor for the appearance of adverse reactions in the patient during ongoing assessment of the treatment. The nurse should monitor vital signs of the patient every 4 hours and not every 24 hours when the patient is hospitalized. The nurse should assess the patient's history of contacts as part of the preadministration assessment and not as part of the ongoing assessment. DOT can only be used by the nurse to administer antitubercular drugs when the patient is at home, at his place of employment, or in school. DOT is not used when the patient is hospitalized.
An HIV-positive patient is in a continuing phase of TB. The patient has completed the initial phase of the treatment program. In the continuing phase, the patient has shown no positive sputum results for 6 months. The nurse knows that under what circumstances does the treatment in the second phase last for 4 months or more?
- A. Positive sputum culture after the completion of initial treatment
- B. Inclusion of pyrazinamide in the initial treatment
- C. Following the same eating habits in the continuing phase
- D. Nausea or vomiting after completing the initial treatment
Correct Answer: A
Rationale: Positive sputum culture after the completion of initial treatment leads to treatment in the second phase lasting for 4 to 7 months. Following the same eating habits (diet) will not cause treatment in the second phase to last for 4 months or more, nor will nausea or vomiting occurring after completing the initial treatment. Noninclusion of pyrazinamide in the initial treatment leads to the second phase lasting for 4 to 7 months or more.