A nurse is caring for a client who is experiencing delirium. Which of the following findings should the nurse expect?

A. Weight loss: Nicotine withdrawal typically leads to increased appetite and potential weight gain rather than weight loss. The absence of nicotine alters metabolism and hunger signals, often causing individuals to consume more food, especially carbohydrates, as a substitute for smoking.
B. Insomnia: Disruptions in sleep patterns are a common symptom of nicotine withdrawal. Nicotine is a stimulant that affects neurotransmitters, and its sudden absence can cause difficulty falling asleep, frequent nighttime awakenings, and restless sleep. Sleep disturbances can persist for several weeks after smoking cessation.
C. Diarrhea: Nicotine withdrawal is more commonly linked to constipation rather than diarrhea. Nicotine stimulates gut motility, and when discontinued, bowel movements may slow down, leading to temporary constipation rather than increased bowel activity.
D. Diaphoresis: While withdrawal can trigger irritability and autonomic symptoms such as mild sweating, excessive sweating is not a primary sign. More common symptoms include mood swings, restlessness, headaches, increased cravings, and difficulty concentrating as the body adjusts to the absence of nicotine.

Anticipated:

• Pyrazinamide: This is a first-line anti-tuberculosis medication used in combination therapy to treat active TB. It helps shorten treatment duration and targets intracellular bacteria.
• Contact precautions: TB is transmitted via airborne droplets, requiring airborne precautions instead. However, contact precautions can still be implemented in addition to airborne precautions.
• Ethambutol: This medication is used to prevent resistance and is part of the standard four-drug regimen for active tuberculosis.
• Isoniazid: A core component of TB treatment, isoniazid is effective against actively dividing Mycobacterium tuberculosis. It is typically given for at least 6 months.
• Airborne precautions: TB is transmitted through airborne droplets, necessitating airborne precautions such as an N95 mask, negative-pressure isolation, and limiting client transport.
• Rifampin: Another first-line anti-tuberculosis drug, rifampin works by inhibiting bacterial RNA synthesis and is a crucial part of combination therapy for TB.

Contraindicated:

• Monthly TB skin test for 1 year: Once TB is confirmed via sputum culture and chest x-ray, repeated skin testing is unnecessary and would not provide additional diagnostic value.