Chapter 22: Drug Therapy for Tuberculosis and Mycobacterium avium Complex Disease

The health care provider is preparing to order rifampin and pyrazinamide for a female client with active tuberculosis. What question should the provider ask this client before confirming this order?

"Are you pregnant?"

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."

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

Decreased absorption of isoniazid

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

What is the recommended treatment for a client younger than 18 years of age with LTBI?

INH for 9 months

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 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.

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.

Which circumstances would warrant a continuation treatment phase of seven months? Select all that apply.

Non-inclusion of pyrazinamide in the initial treatment phase Positive sputum culture after completion of initial treatment

A nurse is assigned to care for a patient with TB in a health care facility. The patient has been prescribed Pyrazinamide. The nurse knows that in which of the following cases is the use of isoniazid contraindicated?

Patients with acute gout

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 female client is prescribed rifampin as part of her antitubercular regimen. She also takes oral contraceptives. The nurse is aware that this combination of medications can produce what effect?

Pregnancy

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.

A 43-year-old man has been diagnosed with active TB. He is prescribed a multiple drug therapy, including INH and rifampin. A priority assessment by the nurse will be to monitor which combination of laboratory test results?

Serum alanine transaminase, aspartate transaminase, and bilirubin

Chest radiography and sputum sample microscopy have confirmed a diagnosis of TB in a 40-year-old man who has a history of type 1 diabetes and who currently has a diabetic foot ulcer. How should the nurse account for this patient's health status when planning care during INH treatment?

The patient will require vigilant monitoring of blood glucose levels.

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)

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

alcohol

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

cause optic neuritis

A nurse is caring for a 52-year-old client who has been diagnosed with a latent tuberculosis infection. The health care provider is considering ordering isoniazid (INH). The preexistence of what condition would require cautious use of INH in this client?

cirrhosis of the liver

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

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

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