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Chapter 24 Coordinating Care for Patients With Infectious Respiratory Disorders
Table 24.11 Medications Used in the Treatment of Tuberculosis—cont'd
Medication Classification
Mechanism of Action Inhibiting mycolic acid biosynthesis, blocking cell wall production
Exemplars
Nursing Implications
Baseline and ongoing laboratory monitoring: l CBC l Chemistries l Renal function l Liver panel l Hepatitis panel l Semen analysis (males) Monitor for: l Appearance of jaundice, persistent GI adverse effects l Abnormal bleeding l Loss of glycemic control in diabetic patients l Development of peripheral neuropathy Patient education: l Complete entire course of prescribed therapy. l Avoid alcohol and medications that affect liver function. l Use contraception during course of therapy. l Do not breastfeed during course of therapy. l Counsel males of reproductive age about potential reproductive hormone and sperm count alterations during therapy.
Pretomanid (Dovprela)
Used as com- bination drug treatment with bedaquiline and linezolid for multidrug- resistant tuberculosis (MDR-TB)
CBC, Complete blood count; GI, gastrointestinal; RUQ, right upper quadrant.
l Alteration in comfort: pain related to pleurisy l Ineffective coping related to isolation and long-term therapy Nursing Interventions ■ Assessments l Oxygen saturation Decreased oxygen saturation occurs with the destruction of lung tissue, lessening the available surface area for air exchange. l Temperature Fever is a result of the inflammatory process. l Sputum Blood-tinged or rusty-colored sputum is present as a result of the destruction of lung parenchyma tissue. l Breath sounds Wheezing from irritated airways; rales and rhonchi from fluid/exudates ■ Actions l Humidified oxygen Humidified oxygen helps ensure adequate oxygen delivery to the tissues and maintains the integrity of the mucous membranes.
l Institute airborne isolation (see Table 24.4). Tuberculosis is an extremely contagious disease. Care must be taken to avoid transmission to other individuals, especially other hospitalized individuals with an increased risk for infection. l Administer antibiotics as ordered. Antibiotics are the definitive treatment for TB and are essential in controlling the spread of the disease. l Ensure adequate nutrition. Adequate caloric intake to maintain optimum body weight is necessary for recovery. Often, patients report substantial weight loss during the time before diagnosis. uals living with or exposed to the infected person. Skin/blood testing helps monitor the spread of TB and ensures prompt treatment if necessary. TB is a reportable disease and is tracked by local, state, and federal health authorities. Healthcare providers are obligated to notify local health departments of an identified TB infection so that an investigation of contacts can be initiated, and any positive TB infections can be identified and treated. ■ Teaching l Stress the importance of skin/blood testing for individ-
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