A client is receiving isoniazid after being diagnosed with tuberculosis. Which information should the nurse include in the client's teaching plan?
Take vitamin B6 daily to prevent peripheral neuropathy.
Your urine and tears may turn orange.
Arrange for a hearing exam to monitor for hearing loss.
Wear sunscreen to prevent photosensitivity reactions.
The Correct Answer is A
Choice A reason:
Isoniazid, an antitubercular medication, can cause peripheral neuropathy, a form of nerve damage characterized by numbness, tingling, or pain, particularly in the hands and feet. This side effect is due to the drug's interference with the normal metabolism of vitamin B6 (pyridoxine). Supplementation with vitamin B6 is recommended to prevent this complication. The normal daily recommended intake for vitamin B6 in adults ranges from 1.3 to 1.7 mg.
Choice B reason:
While it is true that isoniazid can cause discoloration of bodily fluids, turning urine and tears orange, this is not a harmful side effect and does not require intervention. It is, however, important to inform the client of this possibility to prevent alarm.
Choice C reason:
There is no evidence to suggest that routine hearing exams are necessary for clients taking isoniazid unless they have pre-existing hearing conditions or are taking other medications known to affect hearing. Therefore, this is not a standard part of the teaching plan for clients on isoniazid.
Choice D reason:
Photosensitivity reactions are not commonly associated with isoniazid use. While wearing sunscreen is generally good advice for skin protection, it is not specifically related to the administration of isoniazid and thus would not be the primary information to include in the teaching plan.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason:
Dysuria, or painful urination, is a common symptom of cystitis and indicates inflammation of the bladder, often caused by a urinary tract infection (UTI). While it is a symptom to monitor, it does not necessarily indicate progression of the infection.
Choice B reason:
An increased frequency of urination can be a symptom of cystitis due to irritation of the bladder lining. However, like dysuria, it is a common symptom of a UTI and may not signify that the infection is worsening.
Choice C reason:
Pyuria, the presence of white blood cells in the urine, and hematuria, the presence of blood in the urine, are both indicators of inflammation and infection. These symptoms can occur with cystitis but are also not specific to the progression of the infection.
Choice D reason:
Fever is a systemic response to infection and can indicate that a UTI, such as cystitis, is worsening or spreading, possibly to the kidneys, which is known as pyelonephritis. Monitoring for fever is important because it may necessitate more aggressive treatment, such as antibiotics, and possibly hospitalization if the infection is severe.
Correct Answer is C
Explanation
Choice A Reason
Urine negative for ketones is a normal finding and does not typically indicate an acute problem. Ketones in the urine can be a sign of uncontrolled diabetes or starvation, but their absence is expected in a well-nourished individual who is not in a state of diabetic ketoacidosis.
Choice B Reason
Sodium at 135 mg/dL and Potassium at 3.5 mEq/L are within normal ranges. The normal range for serum sodium is approximately 135-145 mEq/L, and for serum potassium, it is around 3.5-5.0 mEq/L. These values do not indicate an immediate concern for the patient with urosepsis.
Choice C Reason
A BUN of 34 mg/dL and Creatinine of 4.2 mg/dL are concerning. The normal range for BUN is approximately 6-20 mg/dL, and for Creatinine, it is about 0.6-1.2 mg/dL for males and 0.5-1.1 mg/dL for females. Elevated levels of BUN and Creatinine indicate impaired kidney function, which can be a complication of urosepsis and the nephrotoxic effects of gentamicin and vancomycin.
Choice D Reason
A white blood cell count of 12,000/mm³ is slightly elevated, which may be expected in a patient with an infection such as urosepsis. The normal range is approximately 4,500-11,000 WBCs/mm³. While this should be monitored, it does not require immediate reporting unless there is a significant change or it is outside the patient's baseline.
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