The client is taking rifampin 600mg PO daily to treat his tuberculosis. Which action by the nurse indicates understanding of the medication?

Appeared in: DHS 2018 shift 1st

Explanation

Rifampin, a first-line antitubercular drug, is known to cause a harmless reddish-orange discoloration of body fluids, including urine, sweat, tears, and saliva.
Informing the patient about this expected side effect is a key nursing action to prevent anxiety and ensure medication adherence.
This discoloration is not a sign of a problem but a normal effect of how the drug is metabolized and excreted.

Option A: Rifampin absorption is decreased by food and should be taken on an empty stomach (1 hour before or 2 hours after meals). Taking it with juice is not recommended.
Option C: There is no specific requirement to take rifampin at bedtime. The most critical timing instruction is to take it on an empty stomach for optimal absorption.
Option D: Antitubercular therapy requires a strict, daily regimen to be effective and prevent drug resistance. Rifampin is never taken on an as-needed (PRN) basis for symptoms like night sweats.

Clinical Relevance

Nursing practice connection: Use the key finding related to Patient education for Rifampin side effects to guide bedside assessment, documentation, and the next nursing action.
Patient education is a critical nursing responsibility that improves medication adherence, reduces patient anxiety, and prevents premature discontinuation of essential therapy like that for tuberculosis.
A key safety point is advising patients on rifampin to avoid wearing soft contact lenses, as the drug can permanently stain them.
What if? If the patient also reported decreased visual acuity and trouble distinguishing between red and green, the nurse should suspect a side effect of Ethambutol (optic neuritis), another common TB drug, and notify the provider immediately.

How to Approach the Question

First, identify the drug in question: Rifampin for tuberculosis.
Recall the key pharmacological properties and common side effects of Rifampin.
Evaluate each option based on standard nursing practice and patient education for this specific drug.
Option A (juice): Consider absorption. Rifampin needs an empty stomach.
Option B (urine color): This is a hallmark, harmless side effect of Rifampin.
Option C (bedtime): Is there a clinical reason for this timing? Not specifically for Rifampin.

Concept Tested & Keywords

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E6 Pharmacology Nursing Lilley 11e Part 3 p. 33-35

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

Practise the full DHS 2018 shift 1st

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