Nokea
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.
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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.
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.
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.
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.
A nurse is preparing to administer ethambutol (Myambutol) to several clients. The nurse would expect to administer the drug cautiously to which clients? Select all that apply.
- A. Clients with hepatic impairment
- B. Clients with hypertension
- C. Clients with cataracts
- D. Clients with diabetic neuropathy
- E. Clients with renal impairment
Correct Answer: A,C,E
Rationale: Ethambutol (Myambutol) should be used cautiously in clients with hepatic or renal impairment and in clients with diabetic retinopathy or cataracts.