A person with active Tuberculosis on treatment with Category I treatment will have maintenance phase for mont… - TMC Staff Nurse - 2019

TMC Staff Nurse - 2019

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Appeared in: TMC Staff Nurse - 2019

Explanation

The standard treatment for new, drug-susceptible Tuberculosis (TB) patients, previously classified as Category I, follows a 6-month regimen.
This regimen is divided into two distinct phases: a 2-month intensive phase and a 4-month continuation (or maintenance) phase.
The goal of the 4-month continuation phase is to eliminate any remaining dormant bacteria (persisters) and prevent a relapse of the disease.
The drugs used during this 4-month phase are typically Isoniazid (H) and Rifampicin (R).

Option A: 2 months is the duration of the initial 'intensive phase' of treatment, not the 'maintenance phase'. During the intensive phase, four drugs (HRZE) are used to rapidly kill the actively multiplying bacteria.
Option B: A 3-month duration is not standard for the maintenance phase in any common drug-sensitive TB regimen. It is, however, the duration of the intensive phase for previously treated patients (formerly Category II).
Option D: 5 months is the duration of the maintenance phase for 'previously treated' TB patients (formerly Category II), not for new 'Category I' patients.

Clinical Relevance

Nursing practice connection: Knowing Tuberculosis Treatment Regimen (Category I/New Patient) helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
Ensuring strict adherence during the 4-month continuation phase is critical. Incomplete treatment is a primary cause of treatment failure, relapse, and the development of drug-resistant TB (MDR-TB).
Nurses play a key role in Directly Observed Therapy (DOTS), where they observe the patient taking their medication to ensure adherence and provide counseling.
Patient education is vital. Nurses must explain that even if symptoms improve after the intensive phase, the full 4-month continuation therapy is necessary to be fully cured.

How to Approach the Question

First, identify the key terms in the question: 'active Tuberculosis', 'Category I', and 'maintenance phase'.
Recall that 'Category I' refers to a new case of TB, who has not been treated before.
Access your knowledge of the standard TB treatment regimen, which is divided into two phases: an initial intensive phase and a subsequent maintenance (or continuation) phase.
Remember the specific durations for a new patient: the intensive phase is 2 months, and the maintenance phase is 4 months.
Compare this information with the given options and select the one that correctly states the duration of the maintenance phase.
Eliminate other options by identifying them as durations for other phases (e.g., 2 months for intensive phase) or other patient categories (e.g., 5 months for previously treated patients).

Concept Tested & Keywords

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E6 Medicine Harrison 22e Part 1 pp. 1436-1438, 1460-1462