Nokea
A client should be educated to limit consumption of which of the following foods to prevent an exaggerated sympathetic-type response when taking isoniazid (INH) for the treatment of tuberculosis? Select all that apply.
- A. Alcohol
- B. Grapes
- C. Bananas
- D. Meats
- E. Broccoli
Correct Answer: A,C,D
Rationale: When isoniazid is taken with foods containing tyramine, such as aged cheese and meats, bananas, yeast products, and alcohol, an exaggerated sympathetic-type response can occur.
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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.
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.
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 patient with TB is undergoing initial therapy in the treatment. The nurse has to administer three or more drugs in combination to the patient. The patient wishes to know the reason for administering a combination of drugs. Which of the following explanations does the nurse offer related to the combination of medications?
- A. Prevents the incidence of liver dysfunction
- B. Slows down bacterial resistance
- C. Slows body's resistance to medication
- D. Prevents further spreading of TB
Correct Answer: B
Rationale: The nurse should inform the patient that administering two to three drugs in combination slows down the development of bacterial resistance in the body. Administering a combination of drugs will not specifically prevent the incidence of liver dysfunction. Using drugs in combination does not slow down the body's resistance to medication, though it does reduce the development of bacterial resistance. Prophylactic treatment helps in preventing the TB from spreading further.
A patient with TB is admitted to a health care facility. The nurse is required to administer an antitubercular drug through the parenteral route to this patient. Which of the following precautions should the nurse take when administering frequent parenteral injections?
- A. Rotate injection sites for frequent parenteral injections.
- B. Monitor patient's vital signs each morning.
- C. Monitor signs of liver dysfunction weekly.
- D. Administer streptomycin to promote nutrition.
Correct Answer: A
Rationale: The nurse should be careful to rotate injection sites when administering frequent parenteral injections. At the time of each injection, the nurse inspects previous injection sites for signs of swelling, redness, and tenderness. The nurse should monitor any signs of liver dysfunction monthly in patients who are being administered antitubercular drugs. The nurse should ensure that pyridoxine, and not streptomycin, is administered to the patient to promote nutrition, but this is only administered if the patient has been living in impoverished conditions and is malnourished. The nurse should monitor the patient's vital signs every 4 hours and not once every morning.