Saunders
NCLEX
Review
Pharmacology
Respiratory
Medications
4.Aspartate
aminotransferase
(AST)
55
U/L
(55
U/L)
Rationale:Because
isoniazid
therapy
can
cause
elevated
hepatic
enzymes
and
hepatitis,
liver
enzymes
are
monitored
when
therapy
is
initiated
and
during
the
first
3
months
of
therapy.
They
may
be
monitored
longer
in
the
client
who
is
older
than
50
years
of
age
or
who
abuses
alcohol.
The
normal
AST
level
is
0
to
35
U/L
(0
to
30
U/L).
The
other
options
are
not
monitored
routinely
and
are
also
normal.
A
client
with
a
documented
exposure
to
tuberculosis
is
on
medication
therapy
with
isoniazid.
The
nurse
is
monitoring
laboratory
results
and
determines
that
which
laboratory
value
indicates
the
need
for
follow-up?
1.Platelet
count
325,000
mm3
(325
×
109/L)
2.Serum
creatinine
1.0
mg/dL
(88.3
mcmol/L)
3.Blood
urea
nitrogen
(BUN)
20
mg/dL
(7.1
mmol/L)
4.Aspartate
aminotransferase
(AST)
55
U/L
(55
U/L)
1,
2,
3,
5
Rationale:Rifabutin
may
be
prescribed
for
a
client
with
active
MAC
disease
and
tuberculosis.
It
inhibits
mycobacterial
DNA-dependent
RNA
polymerase
and
suppresses
protein
synthesis.
Side
and
adverse
effects
include
rash,
gastrointestinal
disturbances,
neutropenia
(low
neutrophil
count),
red-orange–colored
body
secretions,
uveitis
(blurred
vision
and
eye
pain),
myositis,
arthralgia,
hepatitis,
chest
pain
with
dyspnea,
and
flu-like
syndrome.
Vitamin
B6
deficiency
and
numbness
and
tingling
in
the
extremities
are
associated
with
the
use
of
isoniazid. Rifabutin
is
prescribed
for
a
client
with
active
Mycobacterium
avium
complex
(MAC)
disease
and
tuberculosis.
The
nurse
should
monitor
for
which
side
and
adverse
effects
of
rifabutin?
Select
all
that
apply.
1.Signs
of
hepatitis
2.Flu-like
syndrome
3.Low
neutrophil
count
4.Vitamin
B6
deficiency
5.Ocular
pain
or
blurred
vision
6.Tingling
and
numbness
of
the
fingers
3.Diabetes
mellitus
Rationale:Terbutaline
is
a
bronchodilator
and
is
contraindicated
in
clients
with
hypersensitivity
to
sympathomimetics.
It
should
be
used
with
caution
in
clients
with
impaired
cardiac
function,
diabetes
mellitus,
hypertension,
hyperthyroidism,
or
a
history
of
seizures.
The
medication
may
increase
blood
glucose
levels.
Terbutaline
is
prescribed
for
a
client
with
bronchitis.
The
nurse
checks
the
client's
medical
history
for
which
disorder
in
which
the
medication
should
be
used
with
caution?
1.Osteoarthritis
2.Hypothyroidism
3.Diabetes
mellitus
4.Polycystic
disease
2.Report
yellow
eyes
or
skin
immediately.
Rationale:Isoniazid
is
hepatotoxic,
and
therefore
the
client
is
taught
to
report
signs
and
symptoms
of
hepatitis
immediately,
which
include
yellow
skin
and
sclera.
For
the
same
reason,
alcohol
should
be
avoided
during
therapy.
The
client
should
avoid
intake
of
Swiss
cheese,
fish
such
as
tuna,
and
foods
containing
tyramine,
because
they
may
cause
a
reaction
characterized
by
redness
and
itching
of
the
skin,
flushing,
sweating,
tachycardia,
headache,
or
lightheadedness.
The
client
can
avoid
developing
peripheral
neuritis
by
increasing
the
intake
of
pyridoxine
(vitamin
B6)
during
the
course
of
isoniazid
therapy.
NCLEX
Review
Pharmacology
Respiratory
Medications
4.Aspartate
aminotransferase
(AST)
55
U/L
(55
U/L)
Rationale:Because
isoniazid
therapy
can
cause
elevated
hepatic
enzymes
and
hepatitis,
liver
enzymes
are
monitored
when
therapy
is
initiated
and
during
the
first
3
months
of
therapy.
They
may
be
monitored
longer
in
the
client
who
is
older
than
50
years
of
age
or
who
abuses
alcohol.
The
normal
AST
level
is
0
to
35
U/L
(0
to
30
U/L).
The
other
options
are
not
monitored
routinely
and
are
also
normal.
A
client
with
a
documented
exposure
to
tuberculosis
is
on
medication
therapy
with
isoniazid.
The
nurse
is
monitoring
laboratory
results
and
determines
that
which
laboratory
value
indicates
the
need
for
follow-up?
1.Platelet
count
325,000
mm3
(325
×
109/L)
2.Serum
creatinine
1.0
mg/dL
(88.3
mcmol/L)
3.Blood
urea
nitrogen
(BUN)
20
mg/dL
(7.1
mmol/L)
4.Aspartate
aminotransferase
(AST)
55
U/L
(55
U/L)
1,
2,
3,
5
Rationale:Rifabutin
may
be
prescribed
for
a
client
with
active
MAC
disease
and
tuberculosis.
It
inhibits
mycobacterial
DNA-dependent
RNA
polymerase
and
suppresses
protein
synthesis.
Side
and
adverse
effects
include
rash,
gastrointestinal
disturbances,
neutropenia
(low
neutrophil
count),
red-orange–colored
body
secretions,
uveitis
(blurred
vision
and
eye
pain),
myositis,
arthralgia,
hepatitis,
chest
pain
with
dyspnea,
and
flu-like
syndrome.
Vitamin
B6
deficiency
and
numbness
and
tingling
in
the
extremities
are
associated
with
the
use
of
isoniazid. Rifabutin
is
prescribed
for
a
client
with
active
Mycobacterium
avium
complex
(MAC)
disease
and
tuberculosis.
The
nurse
should
monitor
for
which
side
and
adverse
effects
of
rifabutin?
Select
all
that
apply.
1.Signs
of
hepatitis
2.Flu-like
syndrome
3.Low
neutrophil
count
4.Vitamin
B6
deficiency
5.Ocular
pain
or
blurred
vision
6.Tingling
and
numbness
of
the
fingers
3.Diabetes
mellitus
Rationale:Terbutaline
is
a
bronchodilator
and
is
contraindicated
in
clients
with
hypersensitivity
to
sympathomimetics.
It
should
be
used
with
caution
in
clients
with
impaired
cardiac
function,
diabetes
mellitus,
hypertension,
hyperthyroidism,
or
a
history
of
seizures.
The
medication
may
increase
blood
glucose
levels.
Terbutaline
is
prescribed
for
a
client
with
bronchitis.
The
nurse
checks
the
client's
medical
history
for
which
disorder
in
which
the
medication
should
be
used
with
caution?
1.Osteoarthritis
2.Hypothyroidism
3.Diabetes
mellitus
4.Polycystic
disease
2.Report
yellow
eyes
or
skin
immediately.
Rationale:Isoniazid
is
hepatotoxic,
and
therefore
the
client
is
taught
to
report
signs
and
symptoms
of
hepatitis
immediately,
which
include
yellow
skin
and
sclera.
For
the
same
reason,
alcohol
should
be
avoided
during
therapy.
The
client
should
avoid
intake
of
Swiss
cheese,
fish
such
as
tuna,
and
foods
containing
tyramine,
because
they
may
cause
a
reaction
characterized
by
redness
and
itching
of
the
skin,
flushing,
sweating,
tachycardia,
headache,
or
lightheadedness.
The
client
can
avoid
developing
peripheral
neuritis
by
increasing
the
intake
of
pyridoxine
(vitamin
B6)
during
the
course
of
isoniazid
therapy.
