Question

A patient who has active pulmonary tuberculosis (TB) states, "I'm not going to take these TB pills!" Which of these responses by the nurse would be appropriate?

A) "You have a legal right to refuse to take this medication."
B) "You need to sign a Refusal of Treatment Form."
C) "You need to ask your doctor about the possibility of discontinuing the medication."
D) "You should know that the health department can require you to take the medication."

Answer 1

The correct response is D) informing the patient that the health department can require them to take the TB medication due to the importance of completing the treatment to avoid recurrence and resistance.

Step-by-step explanation:

When a patient with active pulmonary tuberculosis (TB) states, "I'm not going to take these TB pills!", the appropriate response from the nurse would be D) "You should know that the health department can require you to take the medication." This is because TB treatment involves a long course of medications, commonly including isoniazid and rifampin, which are essential to fully eradicate the infection and prevent the development of drug-resistant strains of the bacterium Mycobacterium tuberculosis. Discontinuing treatment early can lead to recurrent TB infections and the emergence of multidrug-resistant and extensively drug-resistant TB. Public health concerns necessitate adherence to treatment protocols; therefore, health departments have the authority to enforce treatment to control the spread of this dangerous disease and prevent the development of resistance.

Directly observed therapy (DOT) is one measure used to ensure patient compliance with the medication regimen. The risk of antibiotic resistance is a significant issue in TB management, and adherence to treatment is crucial for both the patient's health and public health. Planning for a patient's nonadherence can include legal and ethical considerations, where the balance between individual rights and public health interests comes into play.