A nurse is reinforcing teaching about environmental modifications in the home with a family member of a client who has Alzheimer's disease. Which of the following information should the nurse include in the teaching?

Choice A Reason:

"The organism that causes TB becomes resistant to antituberculotic medications when you only take one medication." This statement is appropriate.

Tuberculosis bacteria tend to develop resistance to single medications when used alone. Using multiple medications simultaneously helps prevent the bacteria from becoming resistant to any single drug. This strategy, known as combination therapy, is crucial in treating TB effectively and reducing the risk of drug resistance.

When TB bacteria are exposed to just one medication, they can mutate and become resistant to that specific drug. However, using a combination of medications helps ensure that if one medication fails to eliminate some bacteria due to resistance, the other drugs can still work against the resistant strains.

Preventing drug resistance is essential for successful TB treatment and to avoid the need for more complex and less effective medications if resistance develops.

Choice B Reason:

"Taking several antituberculotic medications will protect your liver from toxic effects." This statement is incorrect. While it's true that some antituberculotic medications can have hepatotoxic effects (adverse effects on the liver), the primary reason for using multiple medications in TB treatment isn't solely to protect the liver. The main goal of using multiple medications is to prevent the development of drug-resistant strains of TB bacteria. Protecting the liver is an important consideration in medication selection and monitoring but isn't the primary rationale for multiple medications.

Choice C Reason:

"People who have a severe form of TB need several antituberculotic medications, but those who have less severe TB need just one medication." This statement is incorrect. The severity of TB doesn't determine the number of medications required. The standard treatment approach for TB involves multiple medications, regardless of the severity. This approach aims to prevent the development of drug resistance, ensure effective treatment, and reduce the risk of treatment failure. Using a combination of medications is a fundamental strategy to combat TB effectively.

Choice D Reason:

"Adverse effects occur more often and are more severe when you take only one antituberculotic medication." This statement is incorrect. While it's true that adverse effects can occur with antituberculotic medications, the primary reason for using multiple medications isn't solely to reduce adverse effects. The main concern addressed by using multiple drugs is preventing the development of drug-resistant TB strains. Using a combination of medications reduces the likelihood of resistance developing and increases the effectiveness of treatment, rather than solely minimizing adverse effects.

Choice A Reason:
Digoxin is a cardiac medication used to treat heart conditions such as heart failure and certain arrhythmias. There's no direct chemical relationship between digoxin and sulfa compounds. Generally, digoxin does not contain sulfa components, so it's less likely to cause an allergic reaction in individuals with sulfa allergies. This medication does not typically require clarification for someone with a sulfa allergy.

Choice B Reason:
Prednisone is a corticosteroid used to treat a variety of conditions, including inflammation, allergies, and autoimmune disorders. It does not contain sulfonamide groups in its structure. As a corticosteroid, prednisone is distinct from sulfonamide drugs and is generally considered safe for individuals with sulfa allergies. There is typically no need to clarify this medication for a sulfa-allergic client.

Choice C Reason:
Celecoxib is a nonsteroidal anti-inflammatory drug (NSAID) that belongs to the sulfonamide class. While it is not the same as sulfonamide antibiotics, it contains a sulfonamide moiety in its chemical structure. There's a possibility of cross-reactivity or allergic reactions in individuals with sulfa allergies due to the structural similarity, making it essential to clarify this prescription for someone with a sulfa allergy.

Choice D Reason:
Atorvastatin is a statin medication used to lower cholesterol levels. It does not contain a sulfonamide group in its structure. Statins belong to a different drug class and do not typically pose a risk of cross-reactivity in individuals with sulfa allergies. Therefore, atorvastatin is generally considered safe and does not usually require clarification for a sulfa-allergic client.