The nurse is caring for a 30-year-old American Indian female who is taking Rifater, a drug containing rifampin, isoniazid, and pyrazinamide. The patient asks how long she will have to take the medication. Which response explains when the patient may discontinue the medication?
When the chest x-ray shows no indication of TB
When the TB skin test is no longer positive
When the medication has been taking for 6 months
When three consecutive sputum cultures are negative
The Correct Answer is D
A. When the chest x-ray shows no indication of TB: Chest x-rays can remain abnormal even after successful treatment. Radiographic improvement is not a reliable indicator for stopping therapy.
B. When the TB skin test is no longer positive: The TB skin test often remains positive for life after infection or exposure and does not reflect current disease activity or treatment response.
C. When the medication has been taken for 6 months: Although the standard treatment duration is often 6 months, therapy duration alone is not sufficient without confirming bacteriological clearance via sputum testing.
D. When three consecutive sputum cultures are negative: This is the most reliable indicator that the patient is no longer infectious and the treatment has been effective, especially in active pulmonary TB. It ensures eradication of Mycobacterium tuberculosis.
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Related Questions
Correct Answer is C
Explanation
A. Record the amount of blood loss:While important for documentation, patients often cannot accurately estimate blood loss, especially with nasal bleeding. This step is secondary to assessing the client’s current physiological status following multiple episodes.
B. Ask about the last episode of bleeding and how long it took to stop:This can provide useful information for identifying patterns, but it does not assess the client’s immediate condition or potential complications like hypovolemia or hypertension.
C. Check the client's vital signs:Vital signs offer immediate insight into the client’s circulatory and respiratory status. Multiple episodes of epistaxis in one day could indicate hemodynamic instability or uncontrolled hypertension, making this the priority assessment.
D. Inquire if the client had a headache along with the bleeding:A headache could be associated with elevated blood pressure or sinus involvement, but it is not the most urgent concern after repeated nosebleeds. Assessing vital signs takes precedence.
Correct Answer is B
Explanation
A. Inform the HCP:Notifying the healthcare provider is unnecessary in this case, as tidaling in the water seal chamber is an expected and normal finding. It indicates that the chest tube is patent and responding to changes in thoracic pressure during respiration.
B. Continue to monitor the client:Tidaling reflects normal movement of air and fluid in response to respiration, suggesting the chest tube is functioning correctly. The most appropriate action is to continue monitoring the client.
C. Reinforce the occlusive dressing:There is no indication that the dressing is loose or compromised. Without evidence of air leak or tube displacement, reinforcing the dressing is not necessary at this point.
D. Encourage the client to deep breathe:While deep breathing is important for lung expansion and preventing complications like atelectasis, it is not specifically indicated in response to the observation of tidaling.
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