Nursing Application: Antitubercular Drugs

A client is instructed to complete a sputum collection first thing in the morning and asks why this is necessary. Which response to the patient is the most appropriate?

"Studies have shown that early morning sputum collection has a higher accuracy rate for diagnosis compared to sputum collected later in the day."

Select the words and phrases that are cues to Liliana's illness.

*Coughing *Cough came back even worse *I was better for a while *Her cough returned

Which of the following body systems may be impacted by antitubercular treatment? Select all that apply.

*Eyes *Neurological *Liver

Who is at risk for getting MDR TB? Select all that apply.

*Have spent time with someone known to have drug-resistant TB disease *Develop TB disease again, after having taken TB medicine in the past *Come from areas of the world where drug resistant TB is common *Do not take their TB medicine regularly *Do not take all of their TB medicine as told by their doctor or nurse

Liliana's current medications include dicyclomine, phenytoin, an oral contraceptive, and occasional use of acetaminophen for aches and pains. Which of her medications require either further patient teaching or alternative drug dosing due to drug to drug interactions with common antitubercular treatment? Select all that apply.

*Oral contraceptive *Phenytoin

What teaching is important to provide to Liliana at this time? Select all that apply.

*She needs to take her medication as ordered *She should be encouraged to take care of herself by ensuring adequate nutrition, rest, and relaxation *She should be warned not to consume alcohol because the antitubercular drugs may cause liver toxicity *Compliance with therapy is essential for achieving a cure

1. Liver Function Tests (bilirubin, liver enzymes) 2. Kidney Function Tests (BUN, Creatinine) 3. CBC 4. Uric Acid

1. Baseline for all 2. Streptomycin 3. Streptomycin Isoniazid Rifampin 4. Pyrazinamide

1. Negative 2. HIV-infected persons 3. Recent immigrants (< 5 years) from high- prevalence countries ​ ​ 4. Any person, including persons with no known risk factors for TB. However, targeted skin testing programs should only be conducted among high-risk groups. ​ ​

1. An induration of 0-4 mm 2. Induration of 5-9 mm 3. Induration of 10-14 mm 4. Induration of >= 15 mm

1. Lab Test 2. Medicine 3. Adverse Effect to be Monitored

1. Creatinine clearance 2. Isoniazid Pyrazinamide 3. Nephrotoxicity

1. Drug-resistant TB 2. Multidrug-resistant TB 3. Extensively Drug-resistant TB

1. Resistant to at least one first-line antitubercular drug. 2. Resistant to more than one antitubercular drug. 3. Resistant to isoniazid and rifampin, plus any fluoroquinolone and least one of three injectable second-line drugs.

Treatment for tuberculosis may last for what duration of time?

24 months

What is the vaccine for TB disease called?

Bacille Calmette-Guérin

When is the best time to collect a sputum culture?

Early in the morning

Six weeks after beginning antitubercular drug therapy on an outpatient basis, the patient reports that she still experiences night sweats. What does the nurse identify as the main concern at this time?

Her infection may be resistant to the drug therapy ordered

What is the most important thing a person can do to prevent the spread of multidrug resistant tuberculosis?

Take all their medications exactly as prescribed by their healthcare provider

What is the induration in relation to TB skin testing?

The raised area