A patient about to begin therapy with etanercept has a positive tuberculin skin test. A chest radiograph is negative. The nurse will expect this patient to:
a. begin taking antituberculosis drugs at the beginning of treatment with etanercept.
b. have periodic chest radiographs during treatment with etanercept.
c. have regular monitoring of symptoms to detect active tuberculosis.
d. undergo tuberculosis treatment prior to beginning etanercept treatment.
ANS: D
Since TB in a patient taking etanercept is often extrapulmonary and disseminated, it is important to test all patients for TB. Those who test positive for latent TB should be treated for TB before etanercept treatment is begun. It is not correct to begin TB treatment concurrently with etanercept treatment. Latent TB must be treated and not monitored.
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