What classic sign would the nurse, auscultating the breath sounds of a child hospitalized for an acute asthma attack, expect to find?

Choice A rationale

Ethambutol, an antitubercular medication, is known to cause optic neuritis as a significant adverse effect. This condition manifests as inflammation of the optic nerve, leading to decreased visual acuity, red-green color discrimination impairment, and even blindness. Therefore, regular monitoring of visual acuity and color vision is crucial throughout the duration of ethambutol therapy.

Choice B rationale

Skin color changes are not a primary adverse effect of ethambutol. While some antitubercular drugs like rifampin can cause orange-red discoloration of bodily fluids, ethambutol's adverse effect profile primarily targets the ocular system. Monitoring skin color would not be an effective or necessary assessment for ethambutol therapy.

Choice C rationale

While overall renal function is important for drug excretion, ethambutol does not typically cause significant changes in urine output. It is primarily excreted renally, and dose adjustments may be needed in renal impairment, but direct monitoring of urine output as a specific adverse effect of ethambutol is not the primary concern.

Choice D rationale

Cardiac rhythm disturbances are not a commonly associated adverse effect of ethambutol. Antitubercular medications like isoniazid can rarely cause cardiac issues, but ethambutol's predominant and significant toxicity is to the optic nerve. Therefore, monitoring cardiac rhythm is not a routine or primary assessment for ethambutol therapy.

Choice A rationale

Adherence to the prescribed treatment regimen is paramount for successful tuberculosis (TB) therapy due to the long duration of treatment and the risk of developing drug-resistant strains if medication is taken inconsistently. Scientific principles dictate that maintaining therapeutic drug levels continuously is essential to effectively kill Mycobacterium tuberculosis and prevent the emergence of mutations that confer resistance, ensuring complete eradication of the infection and preventing relapse.

Choice B rationale

While a well-balanced diet supports overall health and immune function, it is secondary to medication adherence in the acute management of tuberculosis. Nutritional support can aid recovery by replenishing energy stores and supporting the immune system, which is crucial for combating chronic infection. However, without consistent pharmacological intervention, dietary factors alone cannot eradicate the Mycobacterium tuberculosis bacilli or prevent disease progression.

Choice C rationale

Follow-up sputum cultures are vital for monitoring treatment effectiveness and confirming cure, but educating on adherence takes precedence. Sputum cultures are a diagnostic tool to assess bacterial load and viability, providing objective evidence of treatment success or failure. They guide decisions regarding treatment duration and drug susceptibility, but their value is contingent upon the client consistently taking their medication to achieve bacterial clearance in the first place.

Choice D rationale

Balancing rest with activity is important for managing fatigue and promoting recovery, but it is less critical than adherence to the medication regimen. Rest allows the body to conserve energy and focus resources on healing, reducing metabolic demands on the already stressed physiological systems during an active infection. Activity, when tolerated, can prevent deconditioning. However, neither directly targets the elimination of the causative organism like antimicrobial therapy.