The nurse cares for a client with an exacerbation of inflammatory bowel disease (IBD). The client tells the nurse about being infected with tuberculosis (TB) 10 years ago but never being medicated. Which prescription is of concern and prompts the nurse to notify the health care provider (HCP)?

Question

The nurse cares for a client with an exacerbation of inflammatory bowel disease (IBD).  The client tells the nurse about being infected with tuberculosis (TB) 10 years ago but never being medicated.  Which prescription is of concern and prompts the nurse to notify the health care provider (HCP)?

Quizplus · Accepted Answer

11ecbb05_c9e1_ecea_b433_459ca95a3a14_MD0009_00 Tuberculosis is an infection caused by the Mycobacterium tuberculosis microorganism. A client with active, primary TB disease has a positive tuberculin skin test (TST), usually feels sick, has symptoms, and can spread the disease to others if not treated with medications. A client with a latent TB infection (LTBI) has a positive TST, negative chest x-ray, is asymptomatic, cannot transmit the disease to others, and can complete a full course of treatment to prevent activation of the disease. Malignancy, immunosuppressant medications, including chemotherapy, and prolonged debilitating disease (eg, HIV), can convert LTBI to active disease. A client with LTBI who begins treatment with a corticosteroid (Prednisone) is at increased risk for conversion to active TB disease. Therefore, the nurse should notify the HCP. (Option A) Lansoprazole (Prevacid) is a proton pump inhibitor used to treat ulcer disease, erosive esophagitis, and gastroesophageal reflux disease. It does not convert LTBI to active disease. (Option B) Metronidazole (Flagyl) is an antimicrobial medication used to treat IBD and does not convert LTBI to active disease. (Option D) Sulfasalazine (Azulfidine) is a gastrointestinal anti-inflammatory medication used to treat IBD and does not convert LTBI to active disease. Educational objective: A client with LTBI has a positive TST, is asymptomatic, and cannot transmit the disease to others. Malignancy, immunosuppressant medications, chemotherapy, and prolonged debilitating disease (eg, HIV) can convert LTBI to active disease.

The Nurse Cares for a Client with an Exacerbation of Inflammatory