Chapter 22: Drug Therapy for Tuberculosis and Mycobacterium avium Complex Disease

What is the recommended treatment for a client younger than 18 years of age with LTBI?

INH for 9 months

The nurse is assessing a client who has been prescribed treatment with isoniazid. What assessment finding would most likely necessitate contacting the health care provider to recommend discontinuing treatment?

jaundice

Tuberculosis typically affects the lungs but can also involve other parts of the body. Which of the following can be affected by the disease?

kidneys, gi/gu and lymph nodes also

A client being treated for drug-resistant active tuberculosis reports experiencing dyspnea accompanied by headache, itching, and diaphoresis over the last 24 hours. Which assessment question asked by the nurse demonstrates an understanding of possible adverse reactions to this medication regimen?

"Did you eat any fish in the past few days?"

A client has been prescribed INH for the treatment of tuberculosis. The nurse teaches the client about dietary restrictions while taking this medication. What is the most important instruction?

"Do not drink beer or red wine while taking this medication because a serious adverse reaction can occur."

A client has just been diagnosed with TB. The client is extremely upset and is asking questions concerning the medications. What is an appropriate response by the nurse?

"You will have multidrug therapy for 6 to 24 months."

A client is to receive rifampin. Which would be most important for the nurse to include in the teaching plan for this client?

"Your urine or sweat may become orange in color."

The nursing instructor is teaching students about drug regimens used for tuberculosis (TB). Who should receive instructions on the different prophylactic uses of isoniazid (INH)? Select all that apply.

-Household members of those recently diagnosed with TB -Those whose tuberculin skin test result has become positive in the last 2 years -Those at risk for TB (such as those with Hodgkin's disease, leukemia, and other serious illnesses) -All clients younger than 35 years with a positive skin test Tuberculosis typically affects the lungs but can also involve other parts of the body. Which of the following can be affected by the disease?

A client has been prescribed 2 tablets of 150 mg isoniazid every day. The available drug is in the form of a 100-mg tablet. To meet the recommended dose, the nurse will administer _______ tablets each time.

3

A nurse works in a community setting and follows clients who have TB. Which clients would likely require the most follow-up from rifampin therapy?

An HIV-positive client

The nurse is teaching a client taking isoniazid. The client also suffers from occasional acid reflux. What should the nurse teach this client about?

Decreased absorption of isoniazid

A client taking isoniazid is worried about the side effects/adverse reactions. The nurse tells the client that a common adverse reaction of isoniazid is which of the following?

Jaundice

A major concern among public health authorities is an increase in drug-resistant tuberculosis (TB) infections. What new evidence suggests a possible cause for this resistant tendency?

Many drug-resistant infections are new infections, especially in those who are immunosuppressed.

A 72-year-old patient with TB is undergoing standard treatment in a health care facility. Which of the following nursing interventions should the nurse perform during ongoing assessment of the treatment?

Monitor for appearance of adverse reactions.

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 six months. The nurse knows that under what circumstances does the treatment in the second phase last for four months or more?

Positive sputum culture after the completion of initial treatment

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?

Rotate injection sites for frequent parenteral injections.

The nurse understands that which is the highest priority when teaching about antitubercular medications?

Taking medications as prescribed

A client asks why three medications are prescribed to treat his tuberculosis. The nurse informs the client of which reasons?

To prevent resistance

A nurse is caring for a 52-year-old client who has been diagnosed with a latent tuberculosis infection. The health care provider is considering ordering isoniazid (INH). The preexistence of what condition would require cautious use of INH in this client?

cirrhosis of the liver

A client is prescribed isoniazid (INH) for the treatment of latent tuberculosis (TB). What assessment data identifies a significantly increased risk for the development of liver damage?

consumes alcohol daily

A 35-year-old man being treated with isoniazid (INH) for exposure to TB has this medical history: diabetes mellitus type 2, hypertension, hyperlipidemia, and coronary artery disease. He drinks one to two glasses of wine on the weekend and smokes two packs of cigarettes per day. Which adverse reaction should the nurse alert the client to report to his health care provider right away?

numbness and tingling in his feet

When a client fails to improve appreciably after 4 weeks of treatment with first-line drugs, what adjuvant first-line antitubercular drug will be considered for inclusion in the existing medication regimen?

pyrazinamide

A client is admitted to hospice with the diagnosis of extensively drug-resistant tuberculosis (XDR-TB). Knowing some of the contributing factors to this disease, the nurse understands this disease is a major indication of what treatment failure?

to adequately diagnose, prevent, and treat MDR-TB