A nurse is instructing a client’s family members about feeding safety for a client who has dysphagia following a stroke. Which of the following instructions should the nurse include?

Choice A reason: Take isoniazid with an antacid. This answer is incorrect because taking isoniazid with an antacid can reduce the absorption and effectiveness of the drug. Isoniazid should be taken on an empty stomach, one hour before or two hours after meals.

Choice B reason: Drink at least 8 ounces of water when you take the pyrazinamide tablet. This answer is incorrect because drinking water with pyrazinamide is not necessary, as this drug does not cause dehydration or kidney problems. However, drinking plenty of fluids is generally recommended for clients with tuberculosis to prevent dehydration and help clear the lungs of secretions.

Choice C reason: Expect your sputum cultures to be negative after 6 months of therapy. This answer is incorrect because expecting sputum cultures to be negative after 6 months of therapy is unrealistic and misleading. The duration of treatment for tuberculosis varies depending on the type and extent of the infection, the drug regimen, and the client's response to the therapy. Some clients may need longer than 6 months to achieve negative sputum cultures.

Choice D reason: Provide a sputum specimen every 2 weeks to the clinic for testing. This answer is correct because providing sputum specimens regularly is important to monitor the effectiveness of the treatment and to determine when the client is no longer infectious.

Choice A reason: This is incorrect. Weight gain is not a manifestation of pulmonary tuberculosis. In fact, weight loss is a common symptom of tuberculosis, as the infection causes the body to use more energy and reduce appetite. Weight loss can also be a result of malnutrition, dehydration, or other complications of tuberculosis.
Choice B reason: This is correct. Night sweats are a manifestation of pulmonary tuberculosis. They occur because the infection causes the body to produce more heat and sweat to fight off the bacteria. Night sweats can also be a sign of fever, which is another symptom of tuberculosis.
Choice C reason: This is correct. Low-grade fever is a manifestation of pulmonary tuberculosis. It occurs because the infection causes the body to raise its temperature to kill the bacteria. Fever can also be accompanied by chills, fatigue, or weakness.
Choice D reason: This is correct. Blood in the sputum is a manifestation of pulmonary tuberculosis. It occurs because the infection causes damage and inflammation to the lungs and the airways, which can bleed and mix with the mucus that is coughed up. Blood in the sputum can also be a sign of a serious complication, such as a ruptured blood vessel or a lung abscess.
Choice E reason: This is incorrect. Flushed cheeks are not a manifestation of pulmonary tuberculosis. They can be caused by various factors, such as embarrassment, exercise, alcohol, or hot weather. Flushed cheeks are not related to the infection or the inflammation of the lungs.