A client with multidrug-resistant tuberculosis (MDR-TB) has a 1-month follow up visit after beginning medication therapy. The client states, "I've had really bad nausea and fatigue, but because my cough has already improved, I knew it would be alright to stop taking the medications." The nurse identifies which priority nursing diagnosis (ND) in this client's care plan?

Question

Quizplus · Accepted Answer

Knowledge deficit is the lack of adequate information required for health recovery, maintenance, and promotion. The priority ND is knowledge deficit of the prescribed therapeutic regimen manifested by the client's verbalization of nonadherence to the prescribed MDR-TB therapy. Medication to treat MDR-TB usually must be taken for 6 to 9 months. The length of the treatment regiment, the cost and amount of medications that must be taken, and the unpleasant side effects all contribute to clients becoming nonadherent with treatment. If clients do not properly complete the entire medication regimen, they risk reactivating the MDR-TB disease, increasing the bacteria's drug-resistance, and spreading the disease to others. The medications cannot be discontinued until therapy is complete. (Option A) Activity intolerance is an insufficient physiological or psychological energy to complete daily activities. In this client, it is related to side effects of the medications and a deconditioned state and is manifested as fatigue or weakness. This is appropriate to include in the care plan but is not the priority ND. (Option B) Imbalanced nutrition, less than body requirements, is an insufficient intake of nutrients to meet metabolic needs. In this client, it is related to inability to ingest foods secondary to nausea, fatigue, and anorexia and is manifested by inadequate caloric intake and a loss of appetite. This is appropriate to include in the care plan but is not the priority ND. (Option D) In this client, nausea is related to medication side effects and is suggested by a verbal report of nausea and loss of appetite. It is appropriate to include this in the care plan but is not the priority ND. Educational objective: The ND, knowledge deficit of the prescribed therapeutic regimen, is appropriate in a client with MDR-TB who is nonadherent to the prescribed medication therapy. Nonadherence increases the risk for recurrence, development of drug-resistant organisms, and spread of TB disease to others.

A Client with Multidrug-Resistant Tuberculosis (MDR-TB) Has a 1-Month Follow