UNIT 8 Antitubercular CHAPTER 30

Question 1

What is Tuberculosis?

Answer 1

Etiology
Mycobacterium tuberculosis
 Acid-fast bacillus
 Transmission
Person to person via droplets
 Coughing, sneezing, talking
 Patients at risk
Immunocompromised
Living or working in high-risk residential settings
Injecting illegal drugs
Health care workers with high-risk patients

Question 2

S/S OF TB

Answer 2

Symptoms
Cough
Fever
Night sweats
Anorexia
Weight loss
Chest pain
Positive acid-fast bacilli in the sputum
Bloody sputum

Question 3

When teaching a patient about isoniazid (INH) and rifampin drug
therapy, which statement will the nurse include?
A. “Take isoniazid with meals.”
B. “Double the amount of vitamin C in your diet to
prevent the peripheral neuropathy associated with
isoniazid therapy.”
C. “Notify the primary health care provider immediately
if your urine turns a red-orange color.”
D. “Avoid exposure to direct sunlight.”

Answer 3

nswer: D
Rationale: The patient should be taught to avoid direct sunlight.
The patient should be taught that INH should be administered 1
hour before or 2 hours after meals. Pyridoxine (vitamin B6) is
used with INH therapy to decrease peripheral neuropathy.
Rifampin use causes the urine to turn a red-orange color.

Question 4

A middle-aged adult is diagnosed with
tuberculosis. Which is true of treatment for this
diagnosis?
A. Treatment may take about 10 days to 2 weeks.
B. Usually two to three agents are needed.
C. The bacteria is usually resistant to treatment
therapy.
D. Treatment for tuberculosis is usually without side
effects.

Answer 4

Answer: B
Rationale: Single-drug therapy for TB is not effective. Usually two
to three drugs are needed. The total treatment plan is usually 6 to
9 months. Although unusual, resistance can occur. The patient
should be taught methods to prevent and report side effects and
adverse reactions to therapy.

Question 5

A patient has developed active tuberculosis and
is prescribed isoniazid and rifampin. Which
information will the nurse include in teaching the
patient about taking this drug? (Select all that
apply.)
A. Isoniazid should be given 1 hour before or 2 hours after
meals.
B. Have periodic eye examinations as ordered by the health
care provider.
C. Compliance with drug regimen is essential.
D. Report numbness, tingling, and burning of hands and
feet.
E. Warn patient that rifampin may turn body fluids a
black color

Answer 5

Answer: A, B, C, D
Rationale: Isoniazid should be given 1 hour before or 2 hours after meals
for better absorption. Periodic eye examinations should be done as these
drugs may cause visual disturbances. Compliance with drug regimen is
essential to prevent drug resistance. Numbness, tingling, or burning of
hands and feet should be reported. Rifampin may turn body fluids a
harmless reddish orange color.

Question 6

both are toxic to liver and kidney

Answer 6

yes

Question 7

pt teaching and interventions

Answer 7

Interventions/teaching
 Administer isoniazid 1 hour before meals or 2 hours after meals.
 Must follow complete regimen
 Collect sputum specimen in early morning.
 Check liver enzymes, kidney function
 Need frequent eye examinations.
 Take vitamin B6 to help prevent peripheral neuropathy.
 Teach sun precautions, to avoid antacids.
 Teach rifampin can turn urine, feces, saliva, sputum, sweat, and
tears red-orange. Contact lenses and clothing can be stained

Question 8

Contraindicated

Answer 8

Contraindications
 Severe renal or hepatic disease
 Alcoholism
 Diabetic retinopathy
 Interactions
 Alcohol
 Antacids

Question 9

Side effects and Adverse effects of Isosizid and Rifampin

Answer 9

Side effects
 Drowsiness
 Photosensitivity
 Dizziness
 GI upset
 Ocular toxicity – isoniazid
 Isoniazid - Vitamin B6 deficiency – peripheral neuropathy
 Rifampin – turns secretions orange
 Hepatoxicity
 Nephrotoxicity