antituberculars
prophylactic antituberculars are used in patients with _____ who have a positive TB test
latent TB
example: Isoniazid (INH)
Isoniazid (INH) interferes with absorption of _____
and this causes ______
B6 (pyridoxine)
peripheral neuropathy (numbness/tingling)
(patient should take vitamin B6 daily)
what is the difference in a local fungal infection vs a systemic fungal infection?
local: can be acquired by contact with an infected person (usually outside the skin)
systemic: may involve the lungs, CNS, or abdomen, usually transmitted through inhalation into the lungs
influenza antivirals (Oseltamivir or Zanamivir) shortens the duration of flu symptoms, and when must this medication be taken?
are you contagious while taking this medication?
within 48 hours of the START of flu symptoms
YES- STILL contagious
Which of the following is an important teaching point for the patient receiving an agent to treat herpes virus or CMV?
a. Stop taking the drug as soon as the lesions have disappeared.
b. Sexual intercourse is fine because as long as you are taking the drug, you are not contagious.
c. Drink plenty of fluids to decrease the drug's toxic effects on the kidneys.
d. There are few associated GI adverse effects.
c. drink plenty of fluids to decrease the drug's toxic effect on the kidneys
first line treatment is used for patients with ____ TB infection
these are the _(most/least)_ effective
what is the acronym for these medications
active
most
RIPE (Rifampin, INH, Pyrazmdamide, Ethambutol)
A patient is taking Isoniazid and notices their skin and eyes have a yellow tint, what should you educate the patient to do if they notice that? because it is a sign of?
report immediately because jaundice is a sign of hepatotoxicity
(teach: NO alcohol, limit acetaminophen)
what is the big adverse effect of Amphotericin B?
what should you monitor for this?
renal injury
monitor creatinine, urine OP, potassium, hematocrit, and magnesium
what labs should be monitored while taking a herpes antiviral (acyclovir) because it can cause ___ dysfunction
can cause kidney dysfunction- must monitor labs such as BUN and creatinine levels
(need to stay hydrated due to risk of renal impairment)
A nurse is infusing IV amphotericin B to a patient with a systemic fungal infection. Based on the adverse effects of the medication, which blood work would NOT need to be evaluated?
a. Complete blood count
b. Albumin level
c. Blood glucose level
d. Renal function
b. albumin level
T or F: a patient can discontinue the mediation if the sputum test is negative
FALSE: need THREE negative tests in a row to be noninfectious
(sputum samples done every 2-4 weeks)
what is the main side effect that Ethambutol can cause?
this medication REALLY affects the eyes
a patient taking Amphotericin B should not take another drug that also causes ____
nephrotoxicity
(ex: loop diuretics)
what toxic effect can Cytomegalovirus antivirals (Ganciclovir and Foscarnet) cause? what should be monitored because of this?
_____ can NOT be near someone with CMV
hematologic toxicity- monitor labs closely for bone marrow suppression
pregnant nurses can NOT be near someone with CMV
(can also cause kidney dysfunction)
A patient taking isoniazid is worried about the negative effects of the drug. The nurse provides information knowing that which is an adverse effect of the drug?
a. Ototoxicity
b. Hepatotoxicity
c. Nephrotoxicity
d. Optic nerve toxicity
b. Hepatotoxicity
what are the major side effects of many antituberculars that need to be reported to the physician?
hepatotoxicity, nephrotoxicity, neurotoxicity, optic neuritis, ototoxicity
A patient has been diagnosed with tuberculosis and is to begin antitubercular therapy with isoniazid, rifampin, and ethambutol. Which actions are appropriate for the nurse to do? (Select all that apply.)
a. Encourage periodic eye examinations.
b. Instruct the patient to take medications with meals.
c. Suggest that the patient take antacids with medications to prevent gastrointestinal distress.
d. Advise the patient to report numbness and tingling of the hands or feet.
e. Alert the patient that body fluids may develop a red-orange color.
f. Teach the patient to avoid direct sunlight and to use sunblock.
A, D, E, F
why are second line medications needed even though they are very toxic?
because of drug resistance
is there a definitive treatment for hepatitis?
main side effect of hepatitis antivirals?
NO definitive treatment; prevention is ket
flu like symptoms
The nurse teaches a patient taking amphotericin B to report which signs and symptoms to the health care provider?
a. Change in sight
b. Decrease in hearing
c. Decrease in urine
d. Painful red rash and blisters
c. Decrease in urine
what is the main side effect of Rifampin and what should you teach the patient
can cause red/orange tears, urine, and sweat
teach patient to wear glasses instead of contact lenses due to discoloration of tears
What are some labs that should be monitored if a patient is taking Pyrazinamide?
what is one main side effect of this drug?
can cause photosensitivity
what is the mechanism of action of systemic anti fungal medications?
a. Breaking apart the fungus nucleus
b. Interfering with fungus DNA production
c. Altering cell permeability of the fungus, leading to cell death
d. Preventing the fungus from absorbing needed nutrients
c. altering cell permeability of the fungus, leading to cell death
Acyclovir has been ordered for a patient with genital herpes. Which nursing interventions are appropriate for this patient? (Select all that apply.)
a. Monitor the patient’s blood urea nitrogen and creatinine.
b. Monitor the patient’s blood pressure for hypertension.
c. Administer intravenous acyclovir over 30 minutes.
d. Advise maintenance of adequate fluid intake.
e. Monitor complete blood count for blood dyscrasias.
A, D, E
A client with tuberculosis is being started on antituberculosis therapy with isoniazid. Before giving the client the first dose, the nurse should ensure that which baseline study has been completed?
a. Electrolyte levels
b. Coagulation times
c. Liver enzyme levels
d. Serum creatinine level
c. liver enzyme levels