Question

The physician has ordered pyrazinamide for a client with tuberculosis. The nurse should tell the client to: A. Schedule frequent eye exams B. Expect red discoloration of his urine C. Increase his fluid intake D. Expect dizziness and ringing in his ears

Short answer

Answer: Increase his fluid intake.

Step-by-step solution

Understand basic information about pyrazinamide

Pyrazinamide is an antibiotic used to treat tuberculosis (TB) alongside other anti-TB medications. It's essential to know the common side effects and necessary precautions to be taken while on this drug, as this will help to determine the right answer.

Analyze the provided options

Analyze each given option and match them with the side effects or precautions associated with pyrazinamide: A. Schedule frequent eye exams - This option is not related to the use of pyrazinamide, as it doesn't cause significant ocular side effects. B. Expect red discoloration of his urine - This option is also not correct, as pyrazinamide doesn't commonly cause red urine discoloration. C. Increase his fluid intake - This option is correct, as pyrazinamide can cause hyperuricemia (excess uric acid in the blood) and gout, which can be managed by increasing fluid intake to facilitate its elimination. D. Expect dizziness and ringing in his ears - Pyrazinamide is not commonly associated with these side effects.

Choose the correct answer

Based on the analysis done in the previous step, the most appropriate response for a nurse to provide to a patient taking pyrazinamide for tuberculosis is: C. Increase his fluid intake

Key concepts

Tuberculosis Treatment

Tuberculosis (TB) is a serious infectious disease that primarily affects the lungs, but it can also spread to other parts of the body. It is caused by the bacterium *Mycobacterium tuberculosis*. Treating TB requires a combination of antibiotics to prevent the development of drug-resistant strains and to effectively kill the bacteria. The treatment regimen often includes drugs such as isoniazid, rifampicin, ethambutol, and pyrazinamide. Pyrazinamide is particularly crucial in shortening the overall duration of treatment. It's typically added during the initial phase of tuberculosis therapy which lasts for about two months. During this time, the drug works effectively in acidic environments, such as those found within cells where the TB bacteria often hide. This combination therapy is the standard approach recommended by health organizations to ensure the disease is controlled and to prevent transmission to others. Proper adherence to the prescribed treatment regimen is crucial for effective control of the disease and to reduce the risk of developing multi-drug resistant strains.

Nursing Education

Nurses play a vital role in the management and treatment of tuberculosis. Their education and understanding of TB treatment are crucial for patient outcomes. They are responsible for administering the correct medications, monitoring side effects, and ensuring that patients adhere to their treatment regimens. Nurses are trained to recognize the importance of combination therapy in TB treatment and understand the specifics of each medication involved, including potential side effects and contraindications. They must keep up-to-date with the latest guidelines and recommendations from health authorities such as the CDC and WHO. Further, nursing education involves guidance on infection control practices to protect themselves and others from contagion. They are taught to apply measures such as isolation techniques and the use of personal protective equipment (PPE) when dealing with active TB cases. Overall, their role is not just clinical but also involves educating the patient about their condition and treatment, fostering a supportive environment that encourages adherence to the medication plan.

Medication Side Effects

Understanding the potential side effects of medications is key to both healthcare professionals and patients. Pyrazinamide, a key drug in TB treatment, can cause several side effects that patients need to be aware of. Common side effects include:

• Increased uric acid levels, which can lead to gout.
• Liver toxicity, requiring regular liver function tests.
• Stomach upset such as nausea and vomiting.

To manage these side effects, patients are advised to increase their fluid intake, which helps to reduce uric acid levels. It's important for healthcare providers to monitor these side effects closely and adjust treatment as needed. Patient education on side effects is critical to ensure they are reported promptly, and treatment can be adjusted. Open communication with healthcare providers is essential to manage these effects effectively and to maintain adherence to TB treatment.

Patient Education

Educating patients on their disease and treatment plan is essential for a successful outcome. For those suffering from tuberculosis, understanding their condition and the importance of their treatment regimen can empower them to take an active role in their recovery. Key educational points include:

• Understanding the nature of tuberculosis and how it spreads.
• The importance of completing the full course of medication, even if symptoms improve early.
• The potential side effects of medications like pyrazinamide and how to manage them.
• Ways to support the treatment, such as increasing fluid intake to manage potential side effects like high uric acid levels.

Patients should be encouraged to ask questions and voice any concerns they have regarding their treatment. Regular follow-up appointments can help reinforce important points and provide ongoing support. A well-informed patient is more likely to adhere to their treatment plan, helping to prevent the spread of TB and reduce the risk of developing resistant strains of the bacterium. Education is a powerful tool in the fight against tuberculosis.