Pharm ch. 22

The nurse is educating a client about ethambutol. Which teaching would be appropriate to include?

"If you have difficulty identifying colors, notify your health care provider." E: A severe reaction of ethambutol is optic neuritis, which includes a decrease in visual acuity and changes in color perception

Pyrazinamide should be used cautiously in which of the following clients?

Clients with diabetes Clients with hepatic impairment Clients with renal impairment Clients with HIV infection

The public health nurse is required to be present for each administered dose of antitubercular therapy administered to clients. What is the reason for this practice?

It prevents inadequate drug therapy.

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

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 need to be administered to the client?

Rifampin and isoniazid

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

Taking medications as prescribed

The nurse is providing health education to a client prescribed isoniazid. What should the nurse instruct the client to avoid?

alcohol

The client reports cough, low-grade fever, anorexia, and night sweats. The client has also been coughing up blood at times. What disease does this client most likely have?

tuberculosis

A client is concerned because his drug regimen for drug-resistant TB is different from that of his friends. Which explanation by the nurse is accurate?

"Treatment is based on drug susceptibility reports."

A nurse is caring for a 39-year-old client who is taking INH, rifampin, and pyrazinamide. The client reports that her urine is red. What is the most likely cause of this discoloration?

Adverse effect of rifampin

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 E: - An HIV-positive person is immunocompromised, and it will take longer to fight the infection. This could increase the difficulty of adherence to the drug regimen. - In addition, many of the drugs used to treat HIV are contraindicated in clients who take rifampin.

A client takes phenytoin for a seizure disorder. Before prescribing isoniazid for the client's tuberculosis, what would the nurse expect the health care provider to do?

Decrease the dose of phenytoin and monitor drug levels closely. E: Isoniazid (INH) increases risks of toxicity with several drugs by inhibiting their metabolism and increasing their blood levels

An 80-year-old client is diagnosed with latent tuberculosis infection. What is a risk for the elderly population when being treated with INH?

Hepatotoxicity

A client is diagnosed with latent tuberculosis infection. The nurse expects that the treatment plan will include which drug?

INH

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.

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.

While discussing tuberculosis, the nursing instructor explains that treatment is typically divided into two phases. What is the second phase called?

The continuation phase

The nurse explains that prophylactic antitubercular therapy is suggested for which people?

Those who have been in close contact with a person with tuberculosis (TB)

A 49-year-old client is diagnosed with TB. The client has a history of alcoholism but has been sober for 3 months now. The client has been prescribed INH. What should the nurse ensure is obtained before initiating the therapy?

baseline liver function test values

A nurse teaching the client with tuberculosis (TB) should state that ethambutol can:

cause optic neuritis

The nurse would include information on which possible adverse effects when educating a client regarding rifampin?

gastrointestinal (GI) upset skin rash discoloration of urine

A nursing instructor is teaching about the tuberculosis (TB) drug pyrazinamide and informs students that the most severe adverse reaction to this drug is which of the following?

hepatotoxicity

The nurse is caring for a female client whose tests confirm she is 10 weeks pregnant and has contracted tuberculosis. The healthcare provider orders a combination of antimycobacterials. What combination of drugs should the nurse identify as safest for this pregnant client?

isoniazid, ethambutol, and rifampin

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

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