After teaching a client who is prescribed a long-acting beta agonist medication, a nurse assesses the client's understanding.
Which statement indicates that the client comprehends the teaching?

Choice A rationale

There is no specific scientific rationale requiring extra vitamin C supplementation while on isoniazid. Isoniazid can cause pyridoxine (vitamin B6) deficiency, which leads to peripheral neuropathy, due to its chemical structure interfering with pyridoxal phosphate metabolism. Therefore, vitamin B6 supplementation is routinely prescribed to prevent this adverse effect, rather than vitamin C, which is not directly involved in this metabolic pathway.

Choice B rationale

Taking isoniazid with milk or juice is generally discouraged as it can interfere with drug absorption. Isoniazid absorption is optimized in an acidic environment and can be reduced by food, particularly dairy products, which can chelate the drug or alter gastric pH. Therefore, consuming it with milk or juice might decrease its bioavailability, leading to sub-therapeutic drug levels and potentially compromising treatment efficacy against Mycobacterium tuberculosis.

Choice C rationale

Isoniazid absorption is best on an empty stomach because food, especially high-fat meals, can significantly decrease its bioavailability. The presence of food in the stomach can delay gastric emptying and interfere with the dissolution and absorption of the drug from the gastrointestinal tract. Optimal absorption ensures that therapeutic drug concentrations are achieved in the bloodstream, which is crucial for effectively inhibiting bacterial cell wall synthesis in Mycobacterium tuberculosis.

Choice D rationale

Isoniazid is not known to cause permanent staining of contact lenses. This side effect is associated with rifampin, another antituberculosis drug, which can cause reddish-orange discoloration of body fluids, including tears, urine, and sweat, due to its chromophore properties and excretion pathways. Isoniazid's mechanism of action and metabolic breakdown do not produce colored metabolites that would result in such staining.

Choice A rationale

Room temperature water is optimal for hydration in asthmatic children because it is less likely to trigger bronchospasm. Cold fluids can irritate the sensitive airways and cause constriction of the smooth muscles surrounding the bronchioles, exacerbating respiratory symptoms in individuals with reactive airways like asthmatics.

Choice B rationale

Carbonated beverages are generally not recommended for asthmatic children. The carbonation can cause bloating and discomfort, potentially leading to increased pressure on the diaphragm and exacerbating breathing difficulties. Additionally, the sugars and artificial ingredients in some carbonated drinks may not be ideal for overall health.

Choice C rationale

Iced fruit juice, similar to other cold beverages, can induce bronchospasm in susceptible individuals with asthma. The cold temperature can trigger airway hyperreactivity, leading to narrowing of the airways and worsening of asthmatic symptoms. Therefore, it is best to avoid very cold drinks.

Choice D rationale

Cold milk, like other cold beverages, can potentially trigger bronchoconstriction in asthmatic children due as it can irritate sensitive airways. Furthermore, some individuals with asthma may have co-existing milk allergies or sensitivities that can exacerbate respiratory symptoms, making it a less optimal choice.