The nurse is completing an admission assessment on a client diagnosed with asthma. What clinical manifestations are typical of the disorder?

Clients on tuberculosis (TB) medications, particularly those on isoniazid, rifampin, and pyrazinamide, are at risk for hepatotoxicity. Therefore, regular monitoring of liver function tests (LFTs) is crucial to detect any liver damage early and adjust treatment as necessary.

Choice A reason:

Liver function studies are essential for clients on TB medications. Drugs like isoniazid, rifampin, and pyrazinamide can cause liver toxicity. Monitoring liver enzymes such as ALT (alanine aminotransferase) and AST (aspartate aminotransferase) helps in early detection of hepatotoxicity, allowing for timely intervention to prevent severe liver damage. Regular LFTs ensure that any adverse effects on the liver are identified and managed promptly.

Choice B reason:

White blood cells (WBCs) are not typically monitored monthly for clients on TB medications. While WBC counts can be affected by various conditions and treatments, they are not specifically indicative of the side effects of TB medications. Monitoring WBCs might be necessary if there are signs of infection or other hematologic issues, but it is not a standard monthly requirement for TB treatment.

Choice C reason:

Coagulation studies are not routinely required for clients on TB medications. These tests are more relevant for patients on anticoagulant therapy or those with bleeding disorders. TB medications do not typically affect coagulation parameters, so regular monitoring of coagulation studies is not necessary unless there is a specific clinical indication.

Choice D reason:

Red blood cells (RBCs) are also not typically monitored monthly for clients on TB medications. While anemia can occur in TB patients, it is not a direct side effect of the medications used to treat TB. Monitoring RBCs might be necessary if there are symptoms of anemia or other hematologic concerns, but it is not a standard part of monthly TB treatment monitoring.

Choice A reason: Assisting in the administration of blood products is typically the responsibility of the circulating nurse. The circulating nurse manages the overall environment of the operating room and ensures that all necessary supplies, including blood products, are available and administered correctly.

Choice B reason: Counting the surgical sponges and instruments is a shared responsibility of both the scrub and circulating nurses. This task is crucial to ensure that no surgical instruments or sponges are left inside the patient, which can prevent serious post-operative complications. The scrub nurse handles the instruments directly, while the circulating nurse verifies the counts, ensuring accuracy and safety.

Choice C reason: Monitoring the traffic in the operating room is primarily the responsibility of the circulating nurse. The circulating nurse ensures that the operating room environment remains sterile and that only authorized personnel are present.

Choice D reason: Monitoring the client’s cardiopulmonary status is typically the responsibility of the anesthesiologist or nurse anesthetist, not the scrub or circulating nurses. These professionals are trained to manage the patient’s vital signs and anesthesia during surgery.