CH 41

A nursing student asks the nurse which patients are more susceptible to tuberculosis infection. Which response by the nurse is correct? Select all that apply.

patients with cancer, patients with malnutrition, patients with HIV

Which is the most common site of infection caused by Mycobacterium tuberculosis?

lung

A primary health care provider has prescribed the administration of a purified protein derivative injection to a patient. How does the nurse identify a positive result?

By observing induration at the site of injection

Which change observed in a patient on antitubercular therapy should the nurse immediately report to the primary health care provider?

Tingling of extremities

Which statement by the patient leads the nurse to believe that the patient has understood the teaching regarding ethambutol?

"I will need to have my eyes checked periodically while I am taking this drug."

Which is a common adverse effect of para-aminosalicylic acid?

Hepatotoxicity

A patient who is on antitubercular therapy complains of numbness and a tingling sensation in the feet. Which antitubercular drug can cause the patient's symptoms?

Isoniazid

Which antitubercular drug can be used as prophylaxis against tuberculosis?

Isoniazid

The nurse is caring for a patient with pulmonary tuberculosis who has been prescribed para-aminosalicylic acid and isoniazid. The nurse finds that the patient has rhinitis caused by an allergy. What will the nurse do in this situation?

Request an order to administer diphenhydramine to the patient

A primary health care provider orders a Mantoux test for a patient with symptoms of tuberculosis. Which action does the nurse take while conducting the Mantoux test?

The nurse intradermally injects 5 tuberculin units of purified protein derivative (PPD).

What information will the nurse provide to a patient receiving rifampin?

A nonharmful side effect of the drug is red-orange discoloration of urine, sweat, and tears.

A patient has a positive Mantoux test. Which test will the provider order next?

Chest radiography

Which is the first-line antitubercular drug?

Isoniazid

The primary health care provider prescribed a sputum culture for a patient with symptoms of tuberculosis and a positive test on chest radiography. Which instruction for collecting the sputum specimen given by the nurse to the patient is appropriate?

"Collect the sputum specimen early in the morning."

The nurse is caring for a pregnant patient with tuberculosis. The patient has been prescribed ethambutol. The patient says to the nurse, "I heard that most antitubercular drugs are not safe to administer during pregnancy." What appropriate response does the nurse provide the patient?

"Ethambutol is a first-line drug and belongs to category B, so it is safe to administer."

Which is the most common organism that causes pulmonary infection characterized by granuloma in the lungs?

Mycobacterium tuberculosis

A primary health care provider has prescribed isoniazid and pyridoxine (vitamin B6) for a patient who has tuberculosis. What is the purpose of administering pyridoxine?

To prevent peripheral nerve damage

A patient is prescribed rifampin for the treatment of tuberculosis. While checking the patient's history, the nurse finds that the patient is on oral contraceptive therapy. What advice on the safe use of rifampin does the nurse give to the patient?

Use other forms of birth control.

The nurse anticipates an order for vitamin supplementation for a patient who is receiving isoniazid therapy. What vitamin supplement is usually used with isoniazid?

Vitamin B6

The nurse teaches a class at a community health care center about the spread, cause, and treatment of tuberculosis. Which statement does the nurse include in the teaching?

"Mycobacterial infection spreads in the body through the blood."

What will the nurse teach a patient who is taking isoniazid?

"Pyridoxine (vitamin B6) will prevent numbness and tingling associated with taking isoniazid."

The nurse is assessing a patient with pulmonary tuberculosis who has been prescribed ethambutol, isoniazid, pyrazinamide, and rifampin. The patient says, "Can you tell me why four medications are prescribed and how I should administer all of them?" What response does the nurse give to the patient?

"You may have a more complete, more rapid response when four medications are given."

The nurse is assessing a patient who has multidrug-resistant tuberculosis (MDR-TB). The nurse informs the patient about the medication, treatment, and precautions to be taken. Which statement does the nurse communicate to the patient?

"Your partner and children should also be treated for tuberculosis."

A patient who has a fever and cough is suspected to have tuberculosis. In what order will the following be performed to make a diagnosis of tuberculosis?

1.Tuberculin skin test 2.Chest radiograph 3.Sputum culture 4.Drug susceptibility tests

What is the result of a drug-drug interaction between isoniazid and an antacid when administered concurrently?

Decreased isoniazid levels

A patient is prescribed isoniazid to treat tuberculosis. The patient has elevated liver enzymes. The nurse will contact the provider to discuss which next step?

Adjust the dose of isoniazid.

The nurse is caring for a patient with tuberculosis who was prescribed rifampin 10 mg/kg PO. Before administering the medication, the nurse checks the patient's weight and finds that it is 60 kg. What does the nurse implement for safe administration of the medication to the patient?

Administers 600 mg of medication to the patient by the oral route

Which nursing intervention is appropriate before initiating streptomycin therapy in a patient with tuberculosis?

Assessing the patient's hearing status

What is the recommended adult dosage of an aminoglycoside antibiotic used for the treatment of active tuberculosis (TB)?

Deep IM: 15 mg/kg/day

A patient has been diagnosed with pulmonary tuberculosis (TB). What test will be necessary to determine whether the TB has spread to other parts of the body?

Brain computed tomography (CT)

The nurse finds that a patient who is receiving treatment with first-line antitubercular drugs for tuberculosis of the bone is not responding to the current therapy. Which other antitubercular drug does the nurse expect will be beneficial to this patient for long-term use?

Cycloserine

The nurse is caring for a patient who is taking rifampin. The patient has a heart rate of 90 beats/min, blood pressure of 100/89 mm Hg, and red-orange urine. What is the nurse's best action?

Document the findings and teach the patient.

The nurse is caring for a patient with tuberculosis. The patient's drug susceptibility test reports are not known. What will the nurse expect the provider to order for this patient?

Four-drug regimen therapy

What is the mechanism of action of streptomycin, which is used for the treatment of tuberculosis?

Inhibition of protein synthesis

The nurse has administered ethambutol to a patient for the treatment of tuberculosis. For which side effect associated with ethambutol use will the nurse assess in the patient?

Optic neuritis

What will the nurse teach patients taking rifampin and isoniazid prophylactically secondary to tuberculosis exposure?

Oral contraceptives become ineffective when given with rifampin.

A patient is treated with rifabutin for tuberculosis. Which adverse effect does the nurse expect in the patient?

Reddish-brown feces

The nurse is caring for a patient who has tuberculosis. The patient has been treated with isoniazid and then with rifampin and isoniazid combination therapy with no improvement in symptoms. What will the nurse suspect?

The patient has multidrug-resistant tuberculosis.