A patient is brought to the emergency department with hemoptysis ...

[sjones]

A patient is brought to the emergency department with hemoptysis and is admitted to the unit diagnosed with tuberculosis.
 
  The prescriber has ordered isoniazid (INH) and rifampin (Rifadin), with the first dose to be given by the nurse now. The nurse should
  a. question the prescriber's order because of concerns about hepatotoxicity.
  b. administer the drugs per the physician's orders.
  c. instruct the patient that he should never have more than two alcoholic drinks per day.
  d. collect a sputum sample.

Question 2

A nurse is conducting education for patients on drug and food combinations that can increase medication toxicity.
 
  The nurse would be correct to teach that which of the following drug and food combinations can cause toxicity? (Select all that apply.)
  a. Lovastatin (Mevacor) and orange juice
  b. Theophylline (Theo-Dur) and caffeine
  c. Spironolactone (Aldactone) and salt substitutes
  d. Maalox and grapefruit juice
  e. Midazolam (Versed) and grapefruit juice

[hugthug12]

Answer to Question 1

ANS: B
The administration of both isoniazid and rifampin is an effective means of treating tuberculosis, and giving them both reduces the dosages of each individually, minimizing the risk of hepatotoxicity.
Although both rifampin and isoniazid are hepatotoxic, there is no indication that the patient is hepatotoxic, therefore there is no need to question the order.
Because both isoniazid and rifampin can lead to hepatotoxicity, alcohol should be avoided by the patient.
Collecting a sputum culture is part of the diagnostic process for tuberculosis and would have been done before the medications were order and started.

Answer to Question 2

ANS: B, C, E
The combination of theophylline and caffeine cause excitation when given concurrently; the combination of spironolactone and salt substitutes can cause very high potassium levels, which can affect the heart; grapefruit juice intensifies the effects of midazolam, resulting in increased sedation.
Lovastatin and grapefruit juice have interactions that result in increased blood levels of Mevacor; however, lovastatin and orange juice do not have this interaction. Maalox and grapefruit juice are not contraindicated and do not result in a drug and food interaction.

[sjones]

Thanks for the timely response, appreciate it

[31809pancho]

TYSM