Question

The public health nurse is providing follow-up care to a client with TB who does not regularly take his medication. Which nursing action would be most appropriate for this client?

A
Ask the client's spouse to supervise the daily administration of the medications.
B
Visit the clinic weekly to ask him whether he is taking his medications regularly.
C
Notify the physician of the client's non-compliance and request a different prescription.
D
Remind the client that TB can be fatal if not taken properly.

Answer 1

The most effective strategy for ensuring a TB patient adheres to their medication is to adopt directly observed therapy (DOT), which allows for supervised administration of medication to the patient.

Step-by-step explanation:

The most appropriate nursing action for a client with TB who does not regularly take his medication would be to implement directly observed therapy (DOT). This involves the nurse supervising the administration of medications, which can be done at a healthcare facility or at the patient's home. DOT is part of the WHO's global strategy to eliminate TB and has been proven effective in ensuring patients complete their treatment courses, thus reducing the risk of antibiotic resistance and the spread of TB.

Nonadherence to TB medication can lead to multidrug-resistant strains, making treatment even more difficult. The Centers for Disease Control and Prevention (CDC) estimates that a significant portion of the global population is infected with TB, with higher rates of nonadherence in underdeveloped areas. DOT addresses these challenges by ensuring treatment continuity and helping prevent the emergence of drug-resistant strains of TB.

Education and counseling may also play a role in supporting the patient's adherence to treatment by reminding them of the potential fatality of TB and its contagious nature. However, DOT remains the most definitive and hands-on approach to monitor and ensure medication compliance.