A client has been taking isoniazid (INH) for tuberculosis for 3 ...

[Charlie]

A client has been taking isoniazid (INH) for tuberculosis for 3 weeks. What laboratory results need to be reported to the health care provider immediately?
 
  a. Albumin: 5.1 g/dL
  b. Alanine aminotransferase (ALT): 180 U/L
  c. Red blood cell (RBC) count: 5.2/mm3
  d. White blood cell (WBC) count: 12,500/mm3

Question 2

A client seen in the emergency department reports fever, fatigue, and dry cough but no other upper respiratory symptoms. A chest x-ray reveals mediastinal widening. What action by the nurse is best?
 
  a. Collect a sputum sample for culture by deep suctioning.
  b. Inform the client that antibiotics will be needed for 60 days.
  c. Place the client on Airborne Precautions immediately.
  d. Tell the client that directly observed therapy is needed.

[srodz]

Answer to Question 1

ANS: B
INH can cause liver damage, especially if the client drinks alcohol. The ALT (one of the liver enzymes) is extremely high and needs to be reported immediately. The albumin and RBCs are normal. The WBCs are slightly high, but that would be an expected finding in a client with an infection.

Answer to Question 2

ANS: B
This client has manifestations of early inhalation anthrax. For treatment, after IV antibiotics are finished, oral antibiotics are continued for at least 60 days. Sputum cultures are not needed. Anthrax is not transmissible from person to person, so Standard Precautions are adequate. Directly observed therapy is often used for tuberculosis.

[Charlie]

Thanks for the timely response, appreciate it

[Joy Chen]

Gracias!