Medical Surgical Tuberculosis #4

Question

A client is being discharged with a diagnosis of tuberculosis. Which important instructions will the nurse provide? Select all that apply.

Answers

  1. Take medication but may stop if the side effects significantly affect quality of life.
    • Rationale:

      This answer is not correct because TB medications should be taken as prescribed, for the entire length of treatment. Compliance with medication regimen is difficult, and clients should be encouraged to take as directed with proper education on the potential adverse effects to expect.

  2. Use other methods of birth control in addition to prescribed contraceptives.
    • Rationale:

      This answer is correct because the use of additional backup birth control is advised since some of the TB medications interfere with the effectiveness of hormonal contraceptives.

  3. Family and others living in the home need to be tested.
    • Rationale:

      This answer is correct because family members and others in the home should also be tested and may require follow-up. TB is an airborne illness so anyone who has been in close contact with the client is at high risk for contracting the illness.

  4. Practice secretion/respiratory hygiene by placing used tissues in a closed bag.
    • Rationale:

      This answer is correct because the client should be taught to practice cough etiquette and respiratory hygiene. The client should also have a ventilated room, sleep alone while the smear is positive, avoid public transportation, and spend time outdoors.

  5. Treatment will likely last for a total of 6-9 months.
    • Rationale:

      This answer choice is correct because the total length of therapy will last 6-9 months. There is an intensive phase lasting for the first 2 months followed by a continuation phase lasting 4 to 7 months.

Overview

The focus of this question is the provision of important client education for a client with active tuberculosis who is being discharged home. Client education should focus on containment of the illness as well as compliance with the medication regimen.

Explanation

Learning Outcomes

Treatment of tuberculosis includes a 6-9 month regimen of a combination of antibiotics. Compliance with treatment is essential to properly treating tuberculosis. In order to help ensure compliance with the regimen, the nurse should teach clients about all possible side effects. Tuberculosis medications can interfere with the effectiveness of oral contraceptives so clients should be taught to use an additional method of birth control during treatment. Clients should be taught that family members and others living in the home should be tested for tuberculosis because the bacteria is easily spread through the air. In order to prevent the spread of infection, tissues should only be used once and disposed of immediately after use in a closed bag.

Test Taking Tip

Tuberculosis medications are frequently tested both on nursing exams and on NCLEX so knowing the most common adverse effects of these medications is important. Specifically the most important client education regarding the medications are compliance with TB medications and can be an issue for many clients.

Video Rationale