A nurse is caring for a client who has asthma and allergies. The client asks the nurse about environmental influences they should avoid. The nurse should inform the client to avoid which of the following?

Choice A reason: This is incorrect. It is not best to take medication with meals. Rifampin is better absorbed when taken on an empty stomach, at least 1 hour before or 2 hours after a meal. Taking rifampin with food can reduce its effectiveness and increase the risk of drug resistance. The nurse should advise the client to take the medication as directed by the doctor, and to avoid foods that can interact with rifampin, such as cheese, yogurt, or alcohol.
Choice B reason: This is incorrect. Treatment with this medication will not last for 1 month. Rifampin is usually given as part of a combination therapy for pulmonary tuberculosis, along with other drugs such as isoniazid, pyrazinamide, and ethambutol. The standard treatment regimen for drug susceptible tuberculosis consists of an intensive phase of 2 months, followed by a continuation phase of 4 or 7 months, depending on the drug regimen and the patient's response. The nurse should inform the client about the duration and the importance of completing the full course of treatment, even if the symptoms improve or the tests become negative.
Choice C reason: This is incorrect. This medication does not cause insomnia. Rifampin does not affect the sleep cycle or the quality of sleep. However, rifampin can cause other side effects, such as nausea, vomiting, diarrhea, headache, or rash. The nurse should instruct the client to report any severe or persistent side effects to the doctor, and to avoid taking over-the-counter drugs or herbal supplements without consulting the doctor, as rifampin can interact with many other medications and reduce their effectiveness.
Choice D reason: This is correct. Urine and other secretions might turn orange. Rifampin can cause a harmless discoloration of body fluids, such as urine, saliva, sweat, tears, or breast milk. The color can range from orange to red or brown, depending on the concentration of the drug and the pH of the fluid. The nurse should reassure the client that this is a normal and expected effect of rifampin, and that it does not indicate any damage to the kidneys or other organs. The nurse should also warn the client that rifampin can stain contact lenses, dentures, or clothing, and advise the client to use disposable lenses, remove dentures before taking the drug, and wear dark colored clothes.

Choice A reason: Administering an inhaled glucocorticoid is not the priority intervention for a child with status asthmaticus. Inhaled glucocorticoids are anti-inflammatory drugs that reduce airway inflammation and prevent asthma attacks, but they do not provide immediate relief of bronchoconstriction.

Choice B reason: Administering a short acting beta agonist (SABA) is the priority intervention for a child with status asthmaticus. SABAs are bronchodilators that relax the smooth muscles of the airways and improve airflow within minutes. They are the first line treatment for acute asthma symptoms and exacerbations.

Choice C reason: Determining the cause of the acute exacerbation is not the priority intervention for a child with status asthmaticus. While it is important to identify and avoid potential triggers of asthma, such as allergens, infections, or stress, this is not an urgent action during a severe asthma attack.

Choice D reason: Obtaining a peak flow reading is not the priority intervention for a child with status asthmaticus. Peak flow is a measure of how quickly the child can blow air out of the lungs, and it can indicate the degree of airway obstruction. However, peak flow measurement is not reliable or feasible during a severe asthma attack, and it should not delay the administration of bronchodilators.