A patient has been taking isoniazid (Nydrazid) for 4 months for ...

[Medesa]

A patient has been taking isoniazid (Nydrazid) for 4 months for latent tuberculosis. The patient reports bilateral tingling and numbness of the hands and feet, as well as feeling clumsy. The nurse expects the provider to:
 
  a. discontinue the isoniazid.
  b. lower the isoniazid dose and add rifampin.
  c. order pyridoxine 100 mg per day.
  d. recheck the tuberculin skin test to see whether it worsens.

Question 2

A patient is about to begin treatment for latent tuberculosis. The patient is an alcoholic, has difficulty complying with drug regimens, and has mild liver damage. What will the nurse tell this patient?
 
  a. You must stop drinking before adequate treatment can begin.
  b. You must take isoniazid with close monitoring of hepatic function.
  c. You must take rifampin daily for 4 months.
  d. You will begin a regimen of isoniazid and rifampin.

[Ptupou85]

Answer to Question 1

ANS: C
Patients sometimes develop peripheral neuropathy, characterized by paresthesias, clumsiness, and muscle aches. If these occur, they may be reversed by administering pyridoxine (vitamin B6). It is not necessary to discontinue the isoniazid. Lowering the isoniazid dose and adding rifampin is not indicated. Rechecking the TST is not indicated.

Answer to Question 2

ANS: B
Isoniazid has an increased incidence of hepatotoxicity, especially when given with alcohol. Patients who consume alcohol or who have liver damage should receive isoniazid with caution and should have close monitoring of liver function. It is unrealistic to ask the alcoholic to stop drinking to undergo treatment. Rifampin is toxic to the liver, especially in alcoholics. Giving both drugs would only increase the risk of hepatotoxicity.

[Medesa]

Excellent

[Alyson.hiatt@yahoo.com]

Gracias!