43 Flashcards
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
A patient is taking rifampin (Rifadin) for active TB. When discussing this drug with the patient, the nurse should stress that
body fluids such as urine, saliva, tears, and sputum may become discolored.
The son of an 82-year-old man calls the clinic and reports that his father missed his morning dose of INH. The nurse should instruct the son to
contact the physician who prescribed the drug therapy.
A 34-year-old male has been diagnosed with TB and will be started on INH therapy. The medication history reveals that he currently takes antacids on a regular basis. The nurse will instruct the patient to take
antacids not less than 1 hour before or 2 hours after taking INH.
A nurse is providing education to a patient who is taking INH. The nurse will advise the patient to avoid which of the following foods?
Cheese, dairy products, and bananas
A nurse works in a community setting and follows patients who have TB. Which of the following patients would likely require the most follow-up from rifampin therapy?
An HIV-positive patient
A 30-year-old African-American woman tested positive for TB and is prescribed isoniazid. The nurse will plan the patient’s care to include close monitoring of the drug therapy because
the patient is at greater risk for high serum levels of the drug.
A nurse is caring for a patient who is taking rifabutin (Mycobutin) for prophylaxis of TB. On follow-up visits to the clinic, the nurse will observe for signs and symptoms of which of the following?
Uveitis and blood dyscrasias
A patient has just been diagnosed with TB. She is extremely upset and is asking questions concerning the medications she will have to take and how long she will have to take them. Which of the following is an appropriate response by the nurse?
“You will have multidrug therapy for 6 to 24 months.”
A 19-year-old Mexican American is about to start taking ethambutol (Myambutol). Before beginning drug therapy, it would be critical for the nurse to assess the patient’s
visual acuity and establish a baseline.
David is a 48-year-old homeless man who presented to a street clinic with complaints of hemoptysis and subsequently tested positive for TB. Which of the following characteristics of David’s present circumstances would preclude treatment with INH?
David is an alcoholic who has hepatitis C (HCV).
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.
A 30-year-old man who recently immigrated to the United States has tested positive for TB and has begun treatment with INH. The nurse who is planning the care of this patient should identify which of the following nursing diagnoses? (Select all that apply.)
A) Pain, acute, related to drug therapy
B) Therapeutic Regimen, Individual, Ineffective Management related to nonadherence to drug treatment
C) Altered Protection related to drug-induced hepatitis
D) Breathing Pattern, Ineffective, related to TB infection
E) Fluid Volume Excess related to TB infection and drug therapy
B,C,D
After several rounds of treatment for TB over past several years, a patient continues to test positive for active TB, a fact that the care team attributes to the patient’s nonadherence to treatment. The patient’s most recent diagnostic workup reveals that he now has multidrug resistant TB. The nurse should anticipate that the patient may require treatment with
a fluoroquinolone.
A middle-aged woman with a complex social and medical history has begun multidrug treatment for TB. Which of the nurse’s following assessment questions is most therapeutic?
“What kinds of routines would work best for you to make sure that you don’t miss any doses of your rifampin?”
