A nurse is caring for a client who has tuberculosis and is taking isoniazid and rifampin. Which of the following outcomes indicates that the client is adhering to the medication regimen?
The client has a negative sputum culture.
The client tests negative for HIV.
The client's liver function test results are within the expected reference range.
The client has a positive purified protein derivative test
The Correct Answer is A
A. The client has a negative sputum culture.
When a client with tuberculosis is adhering to the prescribed medication regimen, their sputum cultures should show a decrease in the number of Mycobacterium tuberculosis bacteria. This indicates that the medication is effectively treating the infection. It's important for clients with tuberculosis to complete their full course of treatment to prevent drug-resistant strains of the bacteria from developing.
B. The client tests negative for HIV: This relates to a different infection (HIV) and doesn't necessarily reflect adherence to the tuberculosis medication regimen.
C. The client's liver function test results are within the expected reference range: While liver function tests are important to monitor due to potential medication side effects, they don't directly indicate medication adherence.
D. The client has a positive purified protein derivative (PPD) test: A positive PPD test indicates exposure to the tuberculosis bacteria in the past but does not reflect current adherence to treatment.
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Related Questions
Correct Answer is A
Explanation
A. Correct Answer: St. John's Wort
Explanation: The nurse should advise the client to avoid taking St. John's Wort. St. John's Wort is an herbal supplement commonly used to treat depression and anxiety. However, it can have significant interactions with various medications, including sertraline. Sertraline is an antidepressant that belongs to the selective serotonin reuptake inhibitor (SSRI) class. St. John's Wort can increase serotonin levels in the brain, and when combined with medications that also affect serotonin levels (such as sertraline), it can lead to a potentially dangerous condition known as serotonin syndrome. Therefore, it's important to avoid St. John's Wort while taking sertraline to prevent adverse effects and interactions.
B. Incorrect Explanation: Coenzyme Q10
Explanation: Coenzyme Q10 (CoQ10) is a naturally occurring antioxidant that plays a role in energy production within cells. While CoQ10 is generally considered safe, it does not have known interactions with sertraline. Therefore, the nurse would not necessarily advise the client to avoid CoQ10 solely based on its potential interaction with sertraline.
C. Incorrect Explanation: Black Cohosh
Explanation: Black cohosh is an herbal supplement often used to manage symptoms of menopause. It is not typically known to have significant interactions with sertraline. However, it's important for the client to discuss any supplements with their healthcare provider before starting them, especially when taking prescribed medications. The nurse might not necessarily advise the client to avoid black cohosh unless there are specific concerns based on the client's medical history.
D. Incorrect Explanation: Ginger Root
Explanation: Ginger root is a commonly used spice and herbal remedy. It does not have known interactions with sertraline and is generally considered safe for most people. However, as with any supplement, it's a good practice to consult with a healthcare provider before starting it, especially when taking prescribed medications like sertraline. The nurse would not necessarily advise the client to avoid ginger root without specific reasons related to the client's health.
Correct Answer is B
Explanation
A. Hypomagnesemia:
Correct Answer: This electrolyte imbalance is the one the nurse should assess the client for.
Explanation: Lithium is primarily excreted by the kidneys, and its excretion can be influenced by factors that affect renal function, including electrolyte imbalances. Hypomagnesemia (low magnesium levels) can potentially reduce the excretion of lithium, leading to increased lithium levels in the blood. This can increase the risk of lithium toxicity, which can be dangerous. Therefore, monitoring magnesium levels is important in clients taking lithium.
B. Hyponatremia:
Incorrect Explanation: While hyponatremia (low sodium levels) is a potential concern, it is not as directly linked to lithium interaction as hypomagnesemia.
Explanation: Lithium can cause diabetes insipidus, which leads to excessive urination and subsequent loss of water and electrolytes, including sodium. However, hyponatremia is not the immediate electrolyte imbalance that arises due to the interaction with lithium.
C. Hypocalcemia:
Incorrect Explanation: Hypocalcemia (low calcium levels) is not a primary concern in the context of lithium use.
Explanation: Lithium does not have a direct interaction with calcium levels. Hypocalcemia is typically not a result of lithium use or its interaction with other factors.
D. Hypokalemia:
Incorrect Explanation: While electrolyte imbalances like hypokalemia (low potassium levels) can have health implications, it is not the primary electrolyte imbalance to be concerned about with lithium use.
Explanation: Hypokalemia is not a direct consequence of lithium interaction. Monitoring potassium levels is important for overall health, but it's not the primary electrolyte imbalance associated with lithium use and its potential interactions.
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