A nurse is caring for a patient who has been prescribed metronidazole. The patient has elevated alanine transaminase (ALT) and aspartate transaminase (AST). What action should the nurse take concerning the administration of metronidazole to this patient?

Choice A reason: Montelukast, a leukotriene receptor antagonist, is not typically tapered or discontinued when symptoms improve. It is used for chronic asthma management to prevent exacerbations by blocking leukotriene-mediated inflammation. Discontinuing it prematurely may lead to symptom recurrence, as it does not provide acute relief.

Choice B reason: Montelukast is an oral medication, not an inhaler, so inhalation technique is irrelevant. It blocks leukotriene D4 receptors to reduce airway inflammation and bronchoconstriction. Proper administration involves daily oral dosing, and no inhalation device is required, making this instruction incorrect for montelukast.

Choice C reason: Montelukast is not used for acute asthma attacks, as its onset is too slow (hours to days). It is a maintenance therapy that prevents inflammation, not a rescue medication like albuterol. Patients should carry short-acting beta-agonists, not montelukast, for acute symptom relief.

Choice D reason: Montelukast must be taken daily on a continuous schedule to maintain its anti-inflammatory effects by blocking leukotriene receptors, even if asthma symptoms improve. Consistent use prevents exacerbations and maintains airway stability, as its mechanism relies on sustained leukotriene inhibition to control chronic asthma symptoms effectively.

Choice A reason: Headache and nervousness are not significant adverse effects of antitubercular drugs like isoniazid or rifampin. These symptoms are nonspecific and less concerning than neurotoxicity. Antitubercular drugs primarily affect the liver, nerves, or blood, making neurological symptoms like numbness more critical to report.

Choice B reason: Numbness and tingling of extremities indicate peripheral neuropathy, a serious adverse effect of isoniazid, which depletes pyridoxine (vitamin B6), impairing nerve function. This requires immediate reporting to adjust therapy or add pyridoxine supplementation, preventing irreversible nerve damage while continuing effective tuberculosis treatment.

Choice C reason: Reddish-orange urine and stool are expected effects of rifampin, which is metabolized to a red-orange compound excreted in bodily fluids. This is harmless and does not require reporting unless accompanied by other symptoms like jaundice, which could indicate hepatotoxicity, a more serious concern.

Choice D reason: Gastrointestinal upset is common with antitubercular drugs like rifampin or pyrazinamide but is not typically severe enough to warrant immediate reporting unless persistent or accompanied by signs of hepatotoxicity. Numbness is a more concerning neurological effect, requiring prompt prescriber notification to prevent complications.