N213: Health Differences Across the Life Span 3

N213: Health Differences Across the Lifespan 3 Study Guide Nursing interventions for tuberculosis: • Assess patients for respiratory status, nutritional status, fever, and medication compliance o Non-hospitalized patients may require public health or home health nursing care • Follow doctor’s treatment orders o Isolation for up to the first three weeks of drug therapy o Drug therapy for up to twelve months with:  Rifampin (RIF): Sometimes used alone or in combination therapies; this drug may cause hepatotoxicity; tell patient it may turn urine and sweat orange  Isoniazid (INH): Used alone or in combination therapy; have patient take on an empty stomach; side effects may include nausea, vomiting, and upset stomach; adverse effects may include neurotoxicity and hepatotoxicity  Streptomycin(SM): Due to widespread drug resistance, this drug is not often used; adverse effects include ototoxicity  Pyrazinamide (PZA): This drug is often used in combination with other therapies to prevent drug resistance; a side effect is stomach upset; adverse effects are hepatotoxicity  Ethambutol (EMB): A combination drug that is often used with Rifampin and Pyrazinamide; side effects include blindness, joint pain, nystagmus, and color blindness; assess vision often with this drug; isoniazid (INH) should be given to anyone exposed and at risk for infection for six months after exposure • Address interventions to ineffective airway clearance first o Position patient to assist with drainage of secretions o Encourage patient to turn, cough, and take deep breaths (TCDB) o Provide oxygen and monitor O2 saturations and arterial blood gases per MDorders o Assess breath sounds frequently o Encourage increased fluid intake o Provide humidity • Offer antipyretics for fever, encourage increased rest for fatigue, and increased fluids for dehydration • For altered nutritional status, offer small, frequent meals, pleasant environment, easy to eat foods, and encourage rest after meals; avoid gassy foods and provide oxygen duringmeals • For ineffective management of therapeutic regimen, patient teaching is the first line of preventative care. Teaching points should include: o Complete teaching about tuberculosis, how it is transmitted, effects on the body, and complications; prevention of transmission by using tissues, handwashing, and isolation precautions o Assist patient with setting up medications; clarify times and dosage, side-effects to watch for, when to call the doctor, and how long to take the medication; instruct about possible drug resistance if medication is stopped too early ©2017 Achieve Test Prep Page 13 of 204