Antitubercular Drugs

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 nurse is caring for a client receiving an antimycobacterial who reports dizziness, headache, and drowsiness. What nursing diagnosis is most likely to relate to this client's adverse drug effects?

Disturbed sensory perception (kinesthetic) related to central nervous system (CNS) effects of the drug

A student nurse needs further explanation about tuberculosis (TB) when making the following statement:

TB can be cured by antitubercular drugs

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

Taking medications as prescribed

A client diagnosed with tuberculosis (TB) has begun multi-drug therapy. The client has asked the nurse why it is necessary to take several different drugs. How should the nurse respond to the client's question?

The use of multiple drugs prevents the development of drug-resistant TB

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 client with a positive sputum culture for TB has been started on streptomycin antitubercular therapy. Upon review of the laboratory results, the nurse notes that the client may be experiencing toxicity if which of the following results is abnormal?

BUN and creatinine

After several rounds of treatment for TB over past several years, a male client continues to test positive for active TB, a fact that the care team attributes to the client's nonadherence to treatment. The client's most recent diagnostic workup reveals that he now has multidrug resistant TB. The nurse should anticipate that the client may require treatment with:

a fluoroquinolone

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

Decreased absorption of isoniazid

A homeless client presented at a street clinic with reports of hemoptysis and subsequently tested positive for TB. Which characteristics of the client's present circumstances would preclude treatment with INH?

an alcoholic who has hepatitis C (HCV)

The nurse is educating a client who has just been diagnosed with tuberculosis (TB). The nurse informs the client that the drug regimen is extensive. What should the nurse tell this client about the drug therapy related to duration?

It usually lasts 6 to 9 months

A client is hospitalized due to nonadherence to an antitubercular drug treatment for a diagnosis of tuberculosis (TB). Which intervention is most important for the nurse to implement?

observing the client taking the medications

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

Which antitubercular medications must be administered on an empty stomach? Select all that apply.

Isoniazid Rifampin Rifabutin

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

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 most commonly used regimen for treatment of TB is divided into two phases: an initial 2-month phase consisting of daily administration of isoniazid (INH), rifampin, and pyrazinamide; and a 4-month continuation phase in which INH and rifampin are administered intermittently.

A client has just been diagnosed with tuberculosis (TB). The nurse can expect to start the client on which drug for the initial phase of treatment?

INH, rifampin, pyrazinamide, ethambutol

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

cause optic neuritis

A client diagnosed with human immunodeficiency virus (HIV) has been infected with Mycobacterium avium complex (MAC) from an indoor pool. Which medication is the recommended treatment for this infection? Select all that apply.

clarithromycin rifabutin rifampin

A client, hospitalized with active tuberculosis, is receiving antitubercular drug therapy. When it becomes apparent that the client is not responding to the medications, what condition will the primary health care provider identify as a possible cause?

drug-resistant tuberculosis.

The nursing student read about a disease called Hansen's disease, which is caused by the bacterium Mycobacterium leprae and is treated with many of the same drugs as are used for TB. The student learned that another name for Hansen's disease iswhich?

eprosy

The nurse understands that tuberculosis (TB) can affect other organs of the body. The term used for TB outside the lungs called which?

extrapulmonary

When administering a secondary drug to a person with tuberculosis (TB), the nurse is treating which type of TB?

extrapulmonary TB

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

A group of nursing students are reviewing information about the transmission of tuberculosis. The students demonstrate understanding when they state transmission occurs from person to person in which manner?

inhalation of infected aerosolized droplets

What is isoniazid's mechanism of action?

inhibits cell wall formation

When a person is diagnosed with tuberculosis, it is most likely that the nurse prepares the family members to be treated prophylactically with which drug?

isoniazid

A client with a diagnosis of rhinosinusitis has been prescribed ciprofloxacin 250 mg SC b.i.d. When contacting the prescriber, the nurse should question the:

route

The client with a diagnosis of TB has a nursing diagnosis of ineffective self-health management. The nurse understands that the most effective method to ensure compliance to TB medications is which of the following?

Direct observed therapy

A nurse is teaching a client about the standard treatment for tuberculosis, which is divided into two phases. Which statement best explains the difference in the two phases?

The continuation phase includes the drugs rifampin and isoniazid

Prior to the administration of antitubercular medications, the nurse anticipates which of the following studies to be completed? Select all that apply.

X-ray Culture and sensitivity Complete blood count Positive sputum culture

Repeated lab work shows positive cultures for a client prescribed drug therapy for tuberculosis (TB) over 4 weeks ago. What are the likely reasons for this failure to achieve treatment goals? Select all that apply.

client has been nonadherent with medication therapy a delay in the initial diagnosis of the client infecting strain of TB is drug resistant

A male client newly diagnosed with tuberculosis (TB) asks the nurse if medications will make him better. The nurse informs the client that sometimes treatment fails and why this happens. What are some reasons for treatment failure? (Select all that apply.)

inadequate initial drug treatment noncompliance with the therapeutic regimen

During treatment with isoniazid, the nurse should plan to meet a specific need by providing the client with what supplement?

liver enzymes Regardless of the route, it is necessary to take liver enzymes prior to beginning administration of isoniazid and then monthly thereafter. Folic acid, pancreatic enzyme, and vitamin D supplements are unnecessary.

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

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

To prevent resistance

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."

The nurse is working with the family of a client who has just been diagnosed with active tuberculosis (TB). Which instructions would the nurse give this family?

You will have to take isoniazid for 6 to 12 months to protect you from TB

When instructing the client with tuberculosis (TB) about the drug Isoniazid, the nurse advises that the most common symptom of toxicity is:

peripheral neuropathy

A nursing student studying pharmacology is focusing on drugs used to treat tuberculosis (TB). This student correctly identifies the classifications of antitubercular drugs as which of the following?

primary and secondary

A nurse is explaining standard treatment for tuberculosis to a client. The nurse would describe the treatment as occurring in how many phases?

2

A client is prescribed isoniazid and rifampin for the treatment of active tuberculosis (TB). The client's medication education should stress that initial symptom improvement is likely to take how long?

2 to 3 weeks

A nurse is assigned to care for a client with tuberculosis who has been prescribed rifampin. What should the nurse confirm to be sure that rifampin is not contraindicated in the client?

The client does not have renal impairment

A client is prescribed rifampin. What information should the nurse include in the client's medication education?

The urine, tears, sweat, and other body fluids will be a discolored red-orange.

When providing health education to a client prescribed isoniazid, the nurse should emphasize the need to avoid what element?

alcohol

A nurse is caring for a 61-year-old client whose health care provider has ordered 2200 mg of ethambutol daily. The recommended dose for ethambutol is 15-25 mg/kg/day. The client weighs 90 kg. Based on dosage calculation, the prescribed dose is:

at the high end of the recommended range

Gary is a construction worker who is diagnosed with leprosy and is prescribed rifampin. Gary is married, an alcoholic, and wears contact lenses. At the time of initiating the therapy, the nurse should inform the client:

he should wear glasses during the therapy People going through rifampin therapy are prone to skin discoloration and discoloration of contact lenses. This is because rifampin can discolor bodily fluids, such as urine, saliva, tears, and sputum. People taking rifampin are not known to have decreased sexual urge or have blood pressure elevation. The client should continue the rifampin therapy for the period suggested by the health care provider, which may or may not be a year.

What adverse effect would most likely necessitate discontinuing treatment with isoniazid?

jaundice

A nurse is caring for an older adult client with tuberculosis. The client has been prescribed ethambutol. Which adverse reactions of ethambutol should the nurse assess for?

optic neuritis

A client, diagnosed with tuberculosis, will soon begin first-line drug treatment. How will rifampin most likely be administered to this client?

orally, on an empty stomach

A nurse is providing education to a client who is taking INH. The nurse is teaching the client to avoid which foods?

Cheese, dairy products, and bananas

The client is taking isoniazid (INH). The nurses is teaching the client the importance of understanding that INH can affect which vitamin?

B6

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