A patient is brought to the emergency department with hemoptysis and is admitted to the unit diagnosed with tuberculosis
The prescriber has ordered isoniazid (INH) and rifampin (Rifadin), with the first dose to be given by the nurse now. The nurse should
a. question the prescriber's order because of concerns about hepatotoxicity.
b. administer the drugs per the physician's orders.
c. instruct the patient that he should never have more than two alcoholic drinks per day.
d. collect a sputum sample.
ANS: B
The administration of both isoniazid and rifampin is an effective means of treating tuberculosis, and giving them both reduces the dosages of each individually, minimizing the risk of hepatotoxicity.
Although both rifampin and isoniazid are hepatotoxic, there is no indication that the patient is hepatotoxic, therefore there is no need to question the order.
Because both isoniazid and rifampin can lead to hepatotoxicity, alcohol should be avoided by the patient.
Collecting a sputum culture is part of the diagnostic process for tuberculosis and would have been done before the medications were order and started.
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