Nokea
A client is in the initial treatment phase for tuberculosis. Which of the following antitubercular drugs would the nurse expect the client to receive during this phase? Select all that apply.
- A. Isoniazid
- B. Rifampin
- C. Ciprofloxacin
- D. Pyrazinamide
- E. Ethambutol
Correct Answer: A,B,D,E
Rationale: The initial phase involves using the following drugs: isoniazid, rifampin, and pyrazinamide, along with ethambutol.
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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.
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.
When completing the preadministration assessment for any antitubercular drug, which of the following would the nurse include? Select all that apply.
- A. Culture and sensitivity testing
- B. Complete blood count
- C. Family and contacts history
- D. Radiographic studies
- E. Medication history
Correct Answer: A,B,C,D,E
Rationale: Preadministration assessment for any antitubercular drug should include culture and sensitivity testing, complete blood count, radiographic studies, medication history, and a family and contacts history for those with active TB.
A nurse is preparing to administer ethambutol (Myambutol) to several clients. The nurse would expect to administer the drug cautiously to which clients? Select all that apply.
- A. Clients with hepatic impairment
- B. Clients with hypertension
- C. Clients with cataracts
- D. Clients with diabetic neuropathy
- E. Clients with renal impairment
Correct Answer: A,C,E
Rationale: Ethambutol (Myambutol) should be used cautiously in clients with hepatic or renal impairment and in clients with diabetic retinopathy or cataracts.
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.