Nokea
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.
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A nurse would expect to administer pyrazinamide cautiously to which clients? Select all that apply.
- A. Clients with diabetes
- B. Clients with hepatic impairment
- C. Clients with renal impairment
- D. Clients with hypertension
- E. Clients with HIV infection
Correct Answer: A,B,C,E
Rationale: Pyrazinamide should be used cautiously in clients during pregnancy and lactation and in clients with hepatic or renal impairment, HIV infection, or diabetes.
A patient with TB has been admitted to a health care facility. When providing instructions related to antitubercular drugs, which of the following should the nurse include to minimize complications related to the GI tract?
- A. Double the dose if earlier dose is missed.
- B. Take prescribed pyrazinamide without regard to food.
- C. Take prescribed ethambutol with food.
- D. Avoid the consumption of alcohol.
Correct Answer: D
Rationale: The nurse should instruct the patient to avoid the consumption of alcohol since alcoholism compounds the patient's difficulties and complicates the general condition of the patient's gastrointestinal tract. The nurse should instruct the patient to take the prescribed dose of ethambutol without regard to food and to take the prescribed pyrazinamide along with food. The nurse should instruct the patient to avoid doubling the dose in case the earlier dose was missed.
A nurse is caring for a patient undergoing the second phase of standard TB treatment. The nurse knows that which of the following combinations of drugs needs to be administered to the client?
- A. Pyrazinamide and dapsone
- B. Rifampin and pyrazinamide
- C. Rifampin and isoniazid
- D. Dapsone and isoniazid
Correct Answer: C
Rationale: The nurse knows that a combination of rifampin and isoniazid drugs should be used during the second phase of standard treatment. Isoniazid, rifampin, and pyrazinamide are not used together as combination drugs in the second phase of standard treatment. Dapsone is used for leprosy and cannot be used in combination with isoniazid or any other drug for TB.
Which of the following is true of secondary drugs to treat tuberculosis? Select all that apply.
- A. Secondary drugs are less effective than primary drugs.
- B. Secondary drugs are more toxic than primary drugs.
- C. Secondary drugs are used to treat extrapulmonary TB.
- D. Secondary drugs are used to treat drug-resistant TB.
- E. Secondary drugs are used as the first line to treat HIV patients with TB.
Correct Answer: A,B,C,D
Rationale: Secondary drugs are used to treat extrapulmonary and drug-resistant TB. Secondary drugs are less effective and more toxic than primary drugs used to treat TB.
The nurse is preparing a teaching plan to foster client adherence to the tubercular drug treatment programs. Which of the following would the nurse include? Select all that apply.
- A. Reinforcing that short-term treatment is ineffective
- B. Reviewing the prescribed drug, doses, and frequency of administration
- C. Using a calendar to designate the days the drug is to be taken for alternate-dosage schedule
- D. Arranging for direct observation therapy with the client and family
- E. Instructing the client about possible adverse reactions and the need to notify prescriber should any occur
Correct Answer: A,B,D,E
Rationale: Teaching points that can be used by the nurse to increase the likelihood for effective therapeutic outcomes include reinforcing that short-term treatment is ineffective; reviewing the drug therapy regimen, including the prescribed drug-doses, and frequency of administration; arranging for direct observation therapy with the client and family; and instructing the client about possible adverse reactions and the need to notify the prescriber should any occur.