Nokea
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.
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Which of the following circumstances would warrant a continuation treatment phase of 7 months? Select all that apply.
- A. Noninclusion of rifampin in the initial treatment phase
- B. Noninclusion of pyrazinamide in the initial treatment phase
- C. HIV positive clients
- D. Cavitary disease after completion of initial treatment
- E. Positive sputum culture after completion of initial treatment
Correct Answer: B,E
Rationale: Noninclusion of pyrazinamide in the initial treatment phase, positive sputum culture after completion of initial treatment, and positive sputum culture after initial treatment in a client with previously diagnosed HIV infections would warrant a continuation of the treatment phase.
A nurse is assigned to care for a patient with TB in a health care facility. The patient has been prescribed pyrazinamide. Which of the following would the nurse identify as a contraindication to the prescribed therapy?
- A. Acute gout
- B. Age younger than 13 years
- C. Diabetic retinopathy
- D. Cataracts
Correct Answer: A
Rationale: The nurse should know that pyrazinamide is contraindicated among patients with acute gout. Pyrazinamide is also contraindicated in patients with acute hepatic or renal impairment and in patients with diabetes mellitus. Ethambutol is contraindicated in patients with diabetic retinopathy, patients with cataracts, and patients who are younger than 13 years of age.
Tuberculosis responds well to long-term treatment with a combination of three or more antitubercular drugs. Which of the following is true regarding the duration of treatment for clients with tuberculosis? Select all that apply.
- A. The initial treatment phase should last for a minimum of 2 months.
- B. The initial treatment phase should last for a maximum of 2 months.
- C. The continuation treatment phase should last for 4 to 7 months.
- D. The continuation treatment phase should last for 6 to 12 months.
- E. Prophylactic treatment should be given for 6 to 9 months.
Correct Answer: A,C,E
Rationale: The Centers for Disease Control and Prevention recommends that treatment begin as soon as possible after diagnosis of TB and include the following: initial treatment phase lasting for a minimum of 2 months, continuation treatment phase lasting for 4 to 7 months, and prophylactic treatment given to family members of the infected individual for 6 to 7 months.
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.
A nursing student is reviewing information about tuberculosis therapy. The student demonstrates understanding of the information when identifying which of the following as true about the initial phase of tuberculosis therapy? Select all that apply.
- A. Drugs are used to kill the rapidly multiplying M tuberculosis.
- B. Drugs are used to prevent drug resistance.
- C. The initial phase lasts approximately 6 to 9 months.
- D. The initial phase lasts approximately 2 months.
- E. The initial phase lasts approximately 4 months.
Correct Answer: A,B,D
Rationale: During the initial phase, which lasts approximately 2 months, drugs are used to kill the rapidly multiplying M. tuberculosis and to prevent drug resistance. The continuing phase lasts approximately 4 months and the entire treatment spans 6 to 9 months.