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The community health nurse prepares a teaching plan for a client with latent
tuberculosis who is prescribed oral isoniazid (INH). Which instructions should the nurse
include? Select all that apply.
Unordered Options Ordered Response
1. Avoid drinking alcohol
2. Expect body fluids to change color to red
3. Report yellowing of skin or sclera
4. Report numbness and tingling of extremities
5. Take with aluminum hydroxide to prevent gastric irritation
Explanation
Isoniazid (INH) is a first-line antitubercular drug prescribed as monotherapy to treat
latent tuberculosis infection. Combined with other drugs, INH is also used for active
tuberculosis treatment. Two serious adverse effects of INH use are hepatotoxicity and
peripheral neuropathy.
A teaching plan for a client prescribed INH includes the following:
• Avoid intake of alcohol and limit use of other hepatotoxic agents (eg,
acetaminophen) to reduce risk of hepatotoxicity (Option 1)
• Take pyridoxine (vitamin B6) if prescribed to prevent neuropathy
• Avoid aluminum-containing antacids (eg, aluminum hydroxide (Maalox))
within 1 hour of taking INH
• Report changes in vision (eg, blurred vision, vision loss)
• Report signs/symptoms of severe adverse effects such as:
o Hepatoxicity (eg, scleral and skin jaundice, vomiting, dark urine, fatigue)
(Option 3)
o Peripheral neuropathy (eg, numbness, tingling of extremities) (Options 4)
(Option 2) Rifampin, another antitubercular drug, often causes a red-orange
discoloration of body fluids (ie, urine, sweat, saliva, tears). However, this effect is not
associated with INH use.
(Option 5) Concurrent use of antacids containing aluminum decreases INH
absorption. The medication may be taken with food if gastric irritation is a concern.
Educational objective:
Common potential side effects of INH include hepatotoxicity (eg, jaundice, vomiting,
dark urine, fatigue) and peripheral neuropathy (eg, numbness, tingling of extremities).
Clients should avoid alcohol use and aluminum-containing antacids, and report any
experienced side effects to the health care provider immediately.
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