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When developing the plan of care for a client receiving antitubercular therapy, the nurse would identify which of the following as a goal? Select all that apply.
- A. Client will state adverse reactions to report.
- B. Client will maintain adequate nutritional status
- C. Client and family demonstrate an understanding of the drug regimen.
- D. Client manages the therapeutic regimen effectively.
- E. Client exhibits a negative sputum culture.
Correct Answer: A,B,C,D,E
Rationale: The goals for a client taking antitubercular drugs can include identification and treatment of adverse reactions including ability to report adverse reaction, maintenance of adequate nutritional status, demonstration of understanding of the drug regimen by client and family, effective management of the therapeutic regimen by the client, and achievement of therapeutic response.
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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 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.
The nurse is preparing a teaching plan to foster client adherence to the tubercular drug treatment programs. Which of the following would the nurse include? Select all that apply.
- A. Reinforcing that short-term treatment is ineffective
- B. Reviewing the prescribed drug, doses, and frequency of administration
- C. Using a calendar to designate the days the drug is to be taken for alternate-dosage schedule
- D. Arranging for direct observation therapy with the client and family
- E. Instructing the client about possible adverse reactions and the need to notify prescriber should any occur
Correct Answer: A,B,D,E
Rationale: Teaching points that can be used by the nurse to increase the likelihood for effective therapeutic outcomes include reinforcing that short-term treatment is ineffective; reviewing the drug therapy regimen, including the prescribed drug-doses, and frequency of administration; arranging for direct observation therapy with the client and family; and instructing the client about possible adverse reactions and the need to notify the prescriber should any occur.
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.
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.