A patient receiving rifampicin should be taught that the effect of the drug could cause?

Appeared in: NHM MP Staff Nurse - 2015

Explanation

Rifampicin is metabolized into a compound that has a reddish-orange color, which is then excreted through various body fluids.
This discoloration affects urine, tears, saliva, sweat, and sputum.
While this side effect is visually alarming, it is harmless and expected.
A key nursing responsibility is to educate the patient about this effect beforehand to prevent anxiety and non-adherence to the treatment.

Option B: Eighth cranial nerve damage, which includes ototoxicity (hearing loss) and vestibular dysfunction (balance problems), is not a characteristic side effect of rifampicin.
Option C: Brain dysfunction is not a typical or common adverse effect associated with rifampicin therapy.
Option D: Vestibular dysfunction, which affects balance, is a component of eighth cranial nerve damage (ototoxicity). This is not caused by rifampicin.

Clinical Relevance

Nursing practice connection: Use the key finding related to Pharmacology and side effects of anti-tuberculosis drugs, specifically Rifampicin to guide bedside assessment, documentation, and the next nursing action.
Patient education is paramount when administering anti-TB drugs to ensure adherence to the long treatment course and prevent the development of drug resistance.
Nurses must warn patients on rifampicin that it can permanently stain soft contact lenses and advise them to use eyeglasses during therapy.
Rifampicin is a potent inducer of cytochrome P450 enzymes, significantly reducing the effectiveness of many medications, including oral contraceptives, anticoagulants (like warfarin), and certain HIV medications. This requires careful medication review and patient counseling.

How to Approach the Question

First, identify the key drug in the question stem, which is 'rifampicin'.
Second, recall the specific and most common side effects associated with rifampicin. Think about the classic 'red-man' like symptoms or unique characteristics.
Third, evaluate each option. Option A describes the well-known reddish-orange discoloration of body fluids.
Fourth, analyze the other options. Eighth cranial nerve damage and vestibular dysfunction are classic side effects of streptomycin. Brain dysfunction is not a typical side effect.
Finally, select the option that accurately describes a hallmark side effect of rifampicin, which is the discoloration of body fluids. This makes it a crucial point for patient teaching.

Concept Tested & Keywords

Concept Tested: Pharmacology and side effects of anti-tuberculosis drugs, specifically Rifampicin.
Stem keywords: rifampicin, patient teaching, effect of the drug
Lead-in keywords: could cause
Negative lead-in flag: false

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E6 Medicine Davidson Principles Practice 24e p. 613-615

E6 Pharmacology Nurses Shanbhag 3e p. 313-315

E6 Nursing Brunner Adult Health 3SA Vol 1 Part 2 p. 1

Practise the full NHM MP Staff Nurse - 2015

Attempt every question from this paper in a timed mock, then review the full solution for each one.