Week 9: Chapter 10

Question 1

A pt has been admitted to the hospital with TB and is prescribed first-line drug therapy. Which drugs should you plan to teach the pt about before discharge?

Answer 1

1. ethambutol (Myambutol)
2. isoniazide (Nydrazid)
3. pyrazinamide (PSA)
4. rifampin (Rifadin)

Question 2

Which A/E is common to all the first-line antitubercular drugs?

Answer 2

Liver toxicity

Question 3

Which precaution is most important to teach a pt who has been prescribed the 4 first-line anti-TB drugs?

Answer 3

Do NOT drink alcoholic beverages while on these drugs

Question 4

Which systemic antifungal drug has the nickname “shake and bake”?

Answer 4

amphotericin B (Amphocin)

Question 5

Which type of superficial fungal infection requires systemic antifungal drug therapy rather than topical antifungal drug therapy?

Answer 5

Infection of the toenail

Question 6

Which antifungal drug is never prescribed for anyone who is pregnant because it causes birth defects?

Answer 6

griseofulvin (Fulvicin)

Question 7

Which precaution is important to teach a pt who is prescribed to use an antifungal cream?

Answer 7

Wash your hands after applying the drug

Question 8

The pt is taking first-line drug therapy for TB reports his urine is now a bright reddish-orange color. What is your best response to this action?

Answer 8

Reassure them that this is an expected S/E of the drug therapy

Question 9

Why is it important to teach a pt taking first-line drug therapy for TB to avoid any products containing acetaminophen or Tylenol for the entire drug therapy period?

Answer 9

Acetaminophen is liver toxic and the combination worsens this A/E

Question 10

Which pt is most at risk for developing peripheral neuropathy as a result of taking isoniazid (Nydrazid) for TB?

Answer 10

A 50 y/o woman who has Type 1 diabetes mellitus

Question 11

The pt with TB who is prescribed the 4 first-line anti-TB drugs asks how long he will have to take all these pills. What is your best response?

Answer 11

Effective therapy requires a minimum of 6 months

Question 12

Why do systemic antifungal drugs uses to treat deep fungal infections cause more S/E than almost any other type of anti-infective drug therapy?

Answer 12

Fungal cells have many similarities to human cells so that these drugs also exert their effects on human cells

Question 13

Which electrolyte value is most important to monitor for a pt who is taking a systemic antifungal drug?

Answer 13

Potassium

Question 14

Which precaution is most important to teach a pt who is prescribed to take an “-azole” antifungal drug?

Answer 14

Drink no more than 24 oz of grapefruit juice daily

Question 15

A patient is complaining of side effects of flushing and chills during the administration of amphotericin B. What is the nurse’s best reaction?

Answer 15

Check to see if any symptom control medications were ordered

Question 16

The nurse is caring for a patient who has been prescribed micafungin (Mycamine) and now reports leg pain. What should the nurse do first?

Answer 16

Assess the other leg.

Question 17

Before giving an antifungal drug, what should the nurse check? (select all that apply)

Answer 17

1. Laboratory values for anemia and liver problems
2. List of all drugs and supplements taken by the patient
3. Laboratory values for kidney impairment

Question 18

The nurse is caring for a clinic patient who has a positive tuberculosis (TB) skin test. What statement made by the patient indicates the need for further teaching?

Answer 18

“The test result will be negative after I start taking TB medication.”

Question 19

The nurse is instructing a patient taking isoniazid (INH). What patient teaching points are most important for people to know who are on this drug? (select all that apply)

Answer 19

1. Males should inform their prescriber if urinary retention occurs.
2. Avoid caffeine in all forms.
3. Notify the prescriber if yellowing of the skin or eyes occurs.
4. Drink 3 L of water daily.

Question 20

The nurse is caring for a patient diagnosed with active tuberculosis (TB). What is the best way for a person to minimize the spread of this disease?

Answer 20

Wear a mask around a person with TB.

Question 21

The nurse is caring for a patient with a systemic antifungal medication. What fungal infection typically requires this type of drug?

Answer 21

Toenail infection

Question 22

A patient has a severe systemic fungal infection. The nurse knows that what antifungal medication is reserved for use only in patients with this condition?

Answer 22

Amphotericin B (Amphocin)

Question 23

The nurse is discharging a patient taking rifampin (RIF). What information is important for the nurse to teach this patient?

Answer 23

1. Take the medication exactly as prescribed.
2. Avoid all alcohol beverages.
3. Oral contraceptives must be supplemented.
4. Soft contact lenses may be stained.

Question 24

The nurse is caring for a patient receiving ethambutol (EMB). The nurse knows why this drug must be used in combination with other antitubercular drugs?

Answer 24

Ethambutol only suppresses reproduction of the TB bacteria.

Question 25

The nurse is caring for a patient taking echinocandins. What techniques are important for the nurse to incorporate to prevent deep vein thrombosis (DVT)? (select all that apply)

Answer 25

1. Ambulate several times a day if the patient’s condition permits.
2. Encourage the patient to drink plenty of fluids.
3. Regularly assess for pain, swelling, and tenderness to lower legs.
4. Administer the drug over at least 6 hours.

Question 26

A patient is taking an antifungal drug. What drug does the nurse know requires grapefruit juice consumption to be limited to no more than 24 ounces per day?

Answer 26

Fluconazole (Diflucan)

Question 27

The nurse is discharging a patient with a prescription for a first-line antitubercular drug. What is the most important information for the nurse to teach the patient?

Answer 27

“Take the medication exactly as prescribed.”

Question 28

The nurse is teaching a patient about taking the antitubercular drug, ethambutol (EMB). What specific patient teaching point should the nurse include?

Answer 28

Notify the prescriber immediately for any changes in vision.