A nurse is providing discharge teaching to a client who has pulmonary tuberculosis and a new prescription for rifampin. Which of the following information should the nurse provide?

It is best to take the medication with meals.

Treatment with this medication will last for 1 month.

This medication can cause insomnia.

Urine and other secretions might turn orange.

Answer and Explanation

The Correct Answer is D

Choice A reason: This is incorrect. It is not best to take medication with meals. Rifampin is better absorbed when taken on an empty stomach, at least 1 hour before or 2 hours after a meal. Taking rifampin with food can reduce its effectiveness and increase the risk of drug resistance. The nurse should advise the client to take the medication as directed by the doctor, and to avoid foods that can interact with rifampin, such as cheese, yogurt, or alcohol.
Choice B reason: This is incorrect. Treatment with this medication will not last for 1 month. Rifampin is usually given as part of a combination therapy for pulmonary tuberculosis, along with other drugs such as isoniazid, pyrazinamide, and ethambutol. The standard treatment regimen for drug susceptible tuberculosis consists of an intensive phase of 2 months, followed by a continuation phase of 4 or 7 months, depending on the drug regimen and the patient's response. The nurse should inform the client about the duration and the importance of completing the full course of treatment, even if the symptoms improve or the tests become negative.
Choice C reason: This is incorrect. This medication does not cause insomnia. Rifampin does not affect the sleep cycle or the quality of sleep. However, rifampin can cause other side effects, such as nausea, vomiting, diarrhea, headache, or rash. The nurse should instruct the client to report any severe or persistent side effects to the doctor, and to avoid taking over-the-counter drugs or herbal supplements without consulting the doctor, as rifampin can interact with many other medications and reduce their effectiveness.
Choice D reason: This is correct. Urine and other secretions might turn orange. Rifampin can cause a harmless discoloration of body fluids, such as urine, saliva, sweat, tears, or breast milk. The color can range from orange to red or brown, depending on the concentration of the drug and the pH of the fluid. The nurse should reassure the client that this is a normal and expected effect of rifampin, and that it does not indicate any damage to the kidneys or other organs. The nurse should also warn the client that rifampin can stain contact lenses, dentures, or clothing, and advise the client to use disposable lenses, remove dentures before taking the drug, and wear dark colored clothes.

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Correct Answer is B

Explanation

Choice A reason: Occasional bubbling in the water seal chamber. This finding does not indicate that the client is experiencing a complication, but rather that the chest tube is functioning properly. Occasional bubbling in the water seal chamber occurs when the client exhales, coughs, or sneezes, and it shows that air is being removed from the pleural space.

Choice B reason: Continuous bubbling in the water seal chamber. This finding indicates that the client is experiencing a complication because it suggests that there is an air leak in the chest tube system. An air leak can prevent the lung from expanding and cause respiratory distress.

Choice C reason: Fluctuations in the fluid level in the water seal chamber. This finding does not indicate that the client is experiencing a complication, but rather that the chest tube is functioning properly. Fluctuations in the fluid level in the water seal chamber occur when the client breathes, and they show that the pressure in the pleural space is changing.

Choice D reason: Constant bubbling in the suction control chamber. This finding does not indicate that the client is experiencing a complication, but rather that the chest tube is functioning properly. Constant bubbling in the suction control chamber occurs when the suction source is connected, and it shows that the suction is working.

A. No fluctuations in the water seal chamber B. No reports of pleuritic chest pain C. Occasional bubbling in the water seal chamber D. Oxygen saturation of 95%

Correct Answer is A

Explanation

Choice A reason: No fluctuations in the water seal chamber. This finding indicates that the lung has expanded and there is no more air leaking from the pleural space. Fluctuations in the water seal chamber are normal when the client breathes, but they should stop when the lung is fully expanded.

Choice B reason: No reports of pleuritic chest pain. This finding does not indicate that the lung has expanded, as pleuritic chest pain can be caused by other factors, such as inflammation or infection of the pleura. Pleuritic chest pain is a sharp pain that worsens with breathing or coughing.

Choice C reason: Occasional bubbling in the water seal chamber. This finding does not indicate that the lung has expanded, as occasional bubbling can be normal or due to a small air leak. Continuous bubbling, however, indicates a large air leak and requires immediate attention.

Choice D reason: Oxygen saturation of 95%. This finding does not indicate that the lung has expanded, as oxygen saturation can be normal or high even with a collapsed lung. Oxygen saturation is the percentage of hemoglobin that is bound to oxygen in the blood.

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A nurse is providing discharge teaching to a client who has pulmonary tuberculosis and a new prescription for rifampin. Which of the following information should the nurse provide?

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