An older patient is receiving standard multidrug therapy for ...

[Themember4]

An older patient is receiving standard multidrug therapy for tuberculosis (TB). The nurse should notify the health care provider if the patient exhibits which finding?
 
  a. Yellow-tinged skin
  b. Orange-colored sputum
  c. Thickening of the fingernails
  d. Difficulty hearing high-pitched voices

Question 2

A patient who is taking rifampin (Rifadin) for tuberculosis calls the clinic and reports having orange discolored urine and tears. Which is the best response by the nurse?
 
  a. Ask if the patient is experiencing shortness of breath, hives, or itching.
  b. Ask the patient about any visual abnormalities such as red-green color discrimination.
  c. Explain that orange discolored urine and tears are normal while taking this medication.
  d. Advise the patient to stop the drug and report the symptoms to the health care provider.

[meganlapinski]

Answer to Question 1

ANS: A
Noninfectious hepatitis is a toxic effect of isoniazid (INH), rifampin, and pyrazinamide, and patients who develop hepatotoxicity will need to use other medications. Changes in hearing and nail thickening are not expected with the four medications used for initial TB drug therapy. Presbycusis is an expected finding in the older adult patient. Orange discoloration of body fluids is an expected side effect of rifampin and not an indication to call the health care provider.

Answer to Question 2

ANS: C
Orange-colored body secretions are a side effect of rifampin. The patient does not have to stop taking the medication. The findings are not indicative of an allergic reaction. Alterations in red-green color discrimination commonly occurs when taking ethambutol (Myambutol), which is a different TB medication.

[Themember4]

Thanks for the timely response, appreciate it

[Joy Chen]

Excellent