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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.
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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 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.
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 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.
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.