TB EAQ
Which statement should the nurse include when teaching a patient about rifampin [Rifadin]? 1 "A harmless side effect will be a red-orange discoloration of body fluids." 2 "Take vitamin B6 to relieve numbness and tingling in the fingers and toes." 3 "Treatment length for the medication is 3 times per day for an 8-week period." 4 "Oral contraception is the preferred method of birth control when using rifampin."
1 Red-orange discoloration of body fluids is a common side effect of rifampin, but it is not harmful. Rifampin does not cause peripheral neuropathy. It does reduce the effectiveness of oral contraceptives, so a nonhormonal form of birth control should be considered. All antitubercular agents need to be taken at least 6 to 24 months to eradicate the slow-growing mycobacterium.
A patient is taking rifampin [Rifadin] for active tuberculosis. Which assessment does the nurse identify as an adverse effect of the drug? 1 Jaundice 2 Moon face 3 Absent deep tendon reflexes 4 Blood glucose level of 60 mg/dL
1 Rifampin is toxic to the liver, which increases the patient's risk of hepatitis. Jaundice is a sign of liver dysfunction and should be monitored. Rifampin has no effect on the blood glucose level or deep tendon reflexes, nor does it cause a moon face.
A patient who has active tuberculosis (TB) is to start a medication regimen that includes pyrazinamide. The nurse identifies a risk for complications if the patient also has which medical condition? 1 Glaucoma 2 Alcoholism 3 Parkinson's disease 4 Rheumatoid arthritis
2 Pyrazinamide is contraindicated in patients with both liver dysfunction and gout. It should be used with caution in patients who abuse alcohol, and liver function studies should be done every 2 weeks. It is not known to cause complications in patients who have Parkinson's disease, rheumatoid arthritis, or glaucoma.
The patient who has tuberculosis is treated with isoniazid. The nurse should monitor for which symptoms that could indicate a vitamin B6 deficiency caused by the medication? 1 Dry skin and brittle nails 2 Alopecia and flaking scalp 3 Oral ulcers and tongue fissures 4 Numbness and tingling in the fingers and toes
4 Dose-related peripheral neuropathy is the most common adverse effect of isoniazid. It results from a vitamin B6 deficiency, which is corrected by taking oral supplements. Symptoms include numbness and tingling in the fingers and toes. Alopecia and flaking scalp, oral ulcers and tongue fissures, and dry skin and brittle nails are not adverse effects of isoniazid-induced vitamin B6 deficiency.
Which statement by a patient taking ethambutol [Myambutol] indicates understanding of adverse effects of the drug? 1 "I will get up slowly when sitting to prevent me from getting dizzy." 2 "I'll increase the fiber and liquids in my diet to prevent constipation." 3 "I'll immediately report any red-orange urine to my healthcare provider." 4 "I'll report any problems with blurred vision or being able to determine colors."
4 Ethambutol can cause optic neuritis resulting in disturbance of color discrimination and blurred vision. Symptoms resolve when the medication is discontinued. Orthostatic hypotension, constipation, and discoloration of urine are not known adverse effects of ethambutol.
To promote treatment adherence in a patient with tuberculosis (TB), the nurse will include which intervention(s)? Select all that apply. A Directly watch the patient take the medication. B Teach the patient about intermittent-dose therapy. C Use a single medication to keep the treatment simple. D Teach the patient about the need for long-term treatment. E Use a signed consent form to enhance patient compliance.
A B D In patients with TB, nonadherence is the most common reason for treatment failure, relapse, and increased medication resistance. Because treatment is necessary for at least 6 months, directly observed therapy (DOT) is a standard of care, as is intermittent dosing. Multiple medication regimens are needed to prevent drug resistance. Education about the length of treatment and the regimen is essential to compliance. A signed consent form does not increase patient compliance.
Which statements will the nurse include when teaching a patient about isoniazid therapy for the treatment of tuberculosis? Select all that apply. A "Take the isoniazid on an empty stomach." B "Use of this drug is associated with vision problems." C "Notify your healthcare provider if your skin starts to turn yellow." D "Your urine will turn reddish orange because of the effects of this drug." E "Numbness or tingling in your extremities is a normal response when taking this drug."
A C Isoniazid should be taken on an empty stomach. Hepatotoxicity is an adverse effect of isoniazid so jaundice should be promptly reported. Numbness and tingling in the extremities is associated with the development of peripheral neuropathy and should be reported to the healthcare provider. Rifampin, not isoniazid, causes discoloration of body fluids. Ethambutol, not isoniazid, is associated with optic neuritis
When teaching a patient about tuberculosis, the nurse should include which statement(s)? Select all that apply. A "Rifampin can cause optic neuritis." B "Treatment of tuberculosis lasts 3 months." C "Isoniazid can cause peripheral neuropathy by depleting vitamin B12." D "Most people infected with Mycobacterium tuberculosis are asymptomatic." E "Most people infected with Mycobacterium tuberculosis harbor dormant bacteria for life if they do not receive drug therapy."
D E Most people infected with M. tuberculosis are symptomatic and harbor dormant bacteria for life if they do not receive drug therapy. Treatment of tuberculosis usually lasts 6 months to 2 years. Isoniazid can cause peripheral neuropathy by depleting vitamin B6. Ethambutol, not rifampin, can cause optic neuritis.
