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A client with diabetes who is taking an oral antidiabetic agent is diagnosed with tuberculosis and is prescribed rifampin. The nurse would instruct the client about which of the following?
- A. Increased risk for bleeding
- B. Greater risk for hepatotoxicity
- C. Increased blood glucose levels
- D. Risk for increased blood pressure
Correct Answer: C
Rationale: Rifampin interacts with oral hypoglycemic agents, leading to a decrease in the effectiveness of the oral hypoglycemic agent, thus increasing blood glucose levels. An increased risk for bleeding occurs when rifampin is given with oral anticoagulants. An increased risk of hepatotoxicity occurs when rifampin is given with isoniazid. When verapamil is given with rifampin, the effectiveness of verapamil is decreased, leading to increased blood pressure levels.
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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 nurse is preparing to teach a client about common adverse reactions associated with rifampin (Rifadin). Which of the following would the nurse include? Select all that apply.
- A. Discoloration of body fluids
- B. Vertigo
- C. Joint pain
- D. Nausea
- E. Rash
Correct Answer: A,B,D,E
Rationale: Common adverse reactions of rifampin include nausea, vomiting, epigastric distress, heartburn, fatigue, vertigo, rash, reddish-orange discoloration of body fluids, hematologic changes, and renal insufficiency.
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.
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 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.