Nokea
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.
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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 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 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.
After teaching a group of nursing students about antitubercular therapy, the instructor determines that the teaching was successful when the students identify which of the following as a primary drug to treat tuberculosis? Select all that apply.
- A. Levofloxacin (Levaquin)
- B. Ethambutol (Myambutol)
- C. Isoniazid (Nydrazid)
- D. Rifampin (Rifadin)
- E. Ciprofloxacin (Cipro)
Correct Answer: B,C,D
Rationale: Ethambutol, isoniazid, pyrazinamide, and rifampin are considered primary drugs in the treatment of TB. Levofloxacin and ciprofloxacin are considered secondary drugs.
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.