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The nurse is preparing the client for discharge.

Which of the following statements indicate the client understands the discharge teaching?

Select the 3 client statements that indicate an understanding of the teaching.

"I will need to take my medications for a total of 6 weeks."

“I am no longer contagious."

"I will need to have someone observe me when I take my medication."

"I can expect my contact lenses to turn red or orange,"

"I should notify my provider if I start taking new over-the-counter or prescription medications."

"I can continue my current alcohol intake."

"I will need to have a repeat Mantoux test in 4 weeks."

Answer and Explanation

Correct Answer : C,D,E

A. "I will need to take my medications for a total of 6 weeks.": TB treatment requires a prolonged course, typically 6 months, not 6 weeks. This statement reflects a misunderstanding of the duration of therapy and could lead to incomplete treatment and drug resistance.

B. “I am no longer contagious.": Clients with active tuberculosis remain contagious until they have received adequate treatment and follow-up testing confirms noninfectious status. Early discharge does not automatically mean the client is no longer a transmission risk.

C. "I will need to have someone observe me when I take my medication.": Directly Observed Therapy (DOT) is recommended to ensure adherence to TB medications, which helps prevent drug resistance and treatment failure. Understanding the importance of DOT indicates comprehension of infection control and treatment compliance.

D. "I can expect my contact lenses to turn red or orange.": Rifampin can discolor body fluids, including tears, causing contact lenses to appear red or orange. Recognizing this harmless side effect demonstrates the client’s understanding of medication effects.

E. "I should notify my provider if I start taking new over-the-counter or prescription medications.": TB medications have multiple drug interactions, and the client must inform the provider of any new medications to prevent adverse effects or reduced drug efficacy.

F. "I can continue my current alcohol intake.": Alcohol use is contraindicated with TB medications because it increases the risk of hepatotoxicity, particularly with isoniazid, rifampin, and pyrazinamide. Continuing alcohol would compromise treatment safety.

G. "I will need to have a repeat Mantoux test in 4 weeks.": Follow-up testing is not required once TB is confirmed by sputum culture. The Mantoux test is used for diagnosis, not monitoring treatment response.

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Correct Answer is D

Explanation

A. Room number of the client: Room numbers can change frequently and do not uniquely identify a client. Relying on room number alone increases the risk of medication errors and is not considered a safe identifier.

B. Name of the client's provider: The provider’s name does not verify the client’s identity and cannot be used to ensure medications are given to the correct individual. It may be relevant for contacting regarding prescriptions but not for client identification.

C. Client’s full medical diagnosis: The diagnosis provides clinical context but is not unique to the client and cannot confirm identity. Multiple clients may share the same diagnosis, so it is insufficient for safe medication administration.

D. Client's telephone number: Using personal identifiers such as telephone number, along with at least one other identifier (e.g., full name, date of birth, or medical record number), helps accurately verify the client’s identity. This reduces the risk of medication errors and ensures safe administration.

A. "Soak in a bathtub of hot water each night." B. "Use a transcutaneous electrical nerve stimulator C. "Lie on your left side with your top leg forward." D. "Obtain a prescription for pramipexole”

Correct Answer is C

Explanation

A. "Soak in a bathtub of hot water each night.": While warm baths can be relaxing, hot water should be avoided during pregnancy due to the risk of maternal hyperthermia, which can harm the fetus. Safety precautions must be emphasized.

B. "Use a transcutaneous electrical nerve stimulator": TENS units are generally used for pain management, not for improving sleep, and their safety during pregnancy for sleep promotion is not well established.

C. "Lie on your left side with your top leg forward.": Side-lying, particularly on the left side, improves maternal comfort, reduces pressure on the vena cava, and can promote better sleep during pregnancy. Using a pillow between the legs can enhance support and relaxation.

D. "Obtain a prescription for pramipexole": Pramipexole is a dopamine agonist used for restless leg syndrome or Parkinson’s disease, but it is not routinely prescribed for sleep disturbances in pregnancy due to potential fetal risks.

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The nurse is preparing the client for discharge.

Which of the following statements indicate the client understands the discharge teaching?

Select the 3 client statements that indicate an understanding of the teaching.