A nurse is providing discharge teaching to a client who has pulmonary tuberculosis and a new prescription for rifampin. Which of the following information should the nurse provide?
It is best to take the medication with meals.
Treatment with this medication will last for 1 month.
This medication can cause insomnia.
Urine and other secretions might turn orange.
The Correct Answer is D
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.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: Droplet precautions are not appropriate for a client who has tuberculosis and a productive cough. Droplet precautions are used to prevent the transmission of infectious agents that are spread by large respiratory droplets, such as influenza, pertussis, or meningitis. Droplet precautions require the use of a surgical mask, eye protection, and gloves when in close contact with the client.
Choice B reason: Protective precautions are not applicable for a client who has tuberculosis and a productive cough. Protective precautions are used to protect immunocompromised clients from exposure to pathogens, such as those undergoing chemotherapy, organ transplantation, or stem cell transplantation. Protective precautions require the use of a HEPA filter, a positive pressure room, and a mask for the client when leaving the room.
Choice C reason: Contact precautions are not sufficient for a client who has tuberculosis and a productive cough. Contact precautions are used to prevent the transmission of infectious agents that are spread by direct or indirect contact with the client or the client's environment, such as Clostridioides difficile, MRSA, or VRE. Contact precautions require the use of gloves and gowns when entering the room and the dedicated use of noncritical patientcare equipment.
Choice D reason: Airborne precautions are the correct type of isolation precautions for a client who has tuberculosis and a productive cough. Airborne precautions are used to prevent the transmission of infectious agents that are spread by small respiratory droplets that can remain suspended in the air, such as tuberculosis, measles, or chickenpox. Airborne precautions require the use of a respirator, such as an N95 mask, a negative pressure room, and a mask for the client when leaving the room.
Correct Answer is C
Explanation
Choice A reason: Performing CPT immediately after the child eats is not a good action for the nurse to plan to take for a child who has cystic fibrosis and a prescription to receive CPT. CPT involves techniques such as percussion, vibration, and postural drainage that help to loosen and remove mucus from the lungs. Performing CPT right after eating can cause nausea, vomiting, or aspiration, especially if the child has gastroesophageal reflux disease (GERD), which is common in cystic fibrosis. The nurse should plan to perform CPT at least 1 hour before or after meals.
Choice B reason: Percussing each lung segment for 15 min is not a necessary action for the nurse to plan to take for a child who has cystic fibrosis and a prescription to receive CPT. Percussion is a technique that involves clapping the chest with a cupped hand to create vibrations that loosen the mucus in the airways. Percussion can be done manually or with a mechanical device. The duration of percussion depends on the amount and location of the mucus, but it is usually done for 3 to 5 min per lung segment. Percussing for 15 min per segment can be excessive and cause bruising, pain, or fatigue.
Choice C reason: Administering albuterol prior to CPT is a beneficial action for the nurse to plan to take for a child who has cystic fibrosis and a prescription to receive CPT. Albuterol is a bronchodilator that helps to relax the smooth muscles of the airways and improve airflow. Administering albuterol before CPT can enhance the effectiveness of the airway clearance techniques by opening up the airways and making it easier to cough up the mucus.
Choice D reason: Performing vibration during the client’s inspirations is not a correct action for the nurse to plan to take for a child who has cystic fibrosis and a prescription to receive CPT. Vibration is a technique that involves applying pressure and shaking the chest wall during exhalation to help move the mucus out of the lungs. Vibration can be done manually or with a mechanical device. Performing vibration during inspiration can interfere with the inhalation of air and oxygen, and reduce the effectiveness of the technique.
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