Nokea
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.
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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 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.
A client is entering the continuation phase of treatment for tuberculosis. Which of the following would the nurse expect the client to receive? Select all that apply.
- A. Isoniazid
- B. Rifampin
- C. Ciprofloxacin
- D. Pyrazinamide
- E. Ethambutol
Correct Answer: A,B
Rationale: The continuation phase includes only the drugs isoniazid and rifampin.
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.
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.