The public health nurse provides care for a client on a directly observed therapy (DOT) program to treat tuberculosis (TB). Which option best describes the care the nurse provides on this program?

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TB is curable if the client completes the prescribed medication regimen. Noncompliance with the treatment plan is a major problem in treating TB due to the length of time drug therapy is required (usually about 6 months) and the associated unpleasant side effects. DOT is an effective patient-centered treatment strategy developed by the World Health Organization that increases compliance with drug therapy, prevents reinfection and the development of multi-drug resistant TB strains, and controls the spread of TB disease worldwide. The public health nurse provides and watches the client swallow every prescribed medication for at least the first 2 months of antitubercular medication therapy, preferably longer. Any designated person (ie, caregiver) can provide the medications and observe the client swallow them. This can take place in any designated area (eg, clinic, home, school, workplace). (Option A) The public health nurse follows the client throughout the treatment period until all sputum smears and cultures are normal, but not in the DOT program. (Option B) The public health nurse gives the client bus tokens or cab fare vouchers to attend scheduled clinic visits as incentives, but not in the DOT program. (Option D) The public health nurse screens all of the client's close contacts for possible infection and prophylactic treatment, but not in the DOT program. Educational objective: Directly observed therapy is a patient-centered treatment strategy, implemented by a health care worker or caregiver, to ensure adherence with drug therapy.

The Public Health Nurse Provides Care for a Client on a Directly