Nokea
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.
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A patient diagnosed with TB is undergoing treatment. The nurse knows that which of the following would be used for household members and other close associates of the client to help prevent the spread of the disease?
- A. Long-term therapy
- B. Prophylactic therapy
- C. DOT therapy
- D. Short-term therapy
Correct Answer: B
Rationale: Prophylactic therapy will prevent or avoid the spreading of TB in household members and other close associates of the diagnosed client. Long-term treatment does not prevent the spreading of TB, though it may eventually cure or reduce the intensity of the disease. Directly observed therapy (DOT) is used to administer drugs two to three times weekly. Using DOT will not prevent the TB from spreading. Usually, short-term therapy is of no value in treating TB. Short-term therapy will also not prevent the disease from spreading.
Which of the following is true of secondary drugs to treat tuberculosis? Select all that apply.
- A. Secondary drugs are less effective than primary drugs.
- B. Secondary drugs are more toxic than primary drugs.
- C. Secondary drugs are used to treat extrapulmonary TB.
- D. Secondary drugs are used to treat drug-resistant TB.
- E. Secondary drugs are used as the first line to treat HIV patients with TB.
Correct Answer: A,B,C,D
Rationale: Secondary drugs are used to treat extrapulmonary and drug-resistant TB. Secondary drugs are less effective and more toxic than primary drugs used to treat TB.
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.
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 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.