The nurse provides discharge teaching to a client starting rifampin for tuberculosis. Which statement by the client indicates correct understanding?
1I will stop rifampin when my cough improves and keep the remaining capsules for future symptoms.
2I can rely on my hormonal contraceptive without backup because rifampin does not affect other drugs.
3My body fluids can turn orange-red, and I will use nonhormonal contraception and complete the regimen.✓ Correct answer
4I should wear my soft contact lenses during therapy because rifampin discoloration washes out completely.
Explanation
Rifampin can discolor urine, sweat, saliva, sputum, and tears orange-red, and it can permanently stain soft contact lenses. It is a potent enzyme inducer that can reduce the reliability of hormonal contraceptives, so an alternative nonhormonal method is recommended. The client must complete the prescribed tuberculosis regimen rather than stopping when symptoms improve.
Clinical reasoning Rifampin commonly discolors body fluids and can stain soft contact lenses. Its enzyme-inducing effect creates clinically important interactions, including reduced hormonal-contraceptive reliability.
Decision rule Teach expected discoloration, interaction precautions, and completion of the full multidrug tuberculosis regimen.
Rifampin enzyme induction — Rifampin accelerates the metabolism of many medications and can reduce the effectiveness of hormonal contraceptives.
Orange-red body fluids — Rifampin can discolor tears, urine, sweat, saliva, and sputum and can permanently stain soft contact lenses.