R/O TB. When do you give RIPE?

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I'm working on a case study for class. This person is r/o TB, r/o lung Ca, r/o MI. The meds ordered include rifampin, isoniazid, PZA and ethambutol. The AFB cultures are ordered, but haven't been taken yet. Patient presents with productive cough with yellow-green secretions and hemoptysis X2 weeks.

Is it okay to start RIPE without any CXR, AFB or any dx results back yet? Can RIPE be started based solely on signs and symptoms? I've been reading that AFB cultures take 6 weeks to grow and a CXR can come back normal for someone with TB.

Any input is appreciated. Thanks in advance.

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Specializes in Rehab, Ortho-Spine, Med-Surg, & Psych.

Hello,

I do not mean to be mean, but we're not here to answer your homework questions. We're here to support your personal/professional questions and educational goals.

Kindly, Devon Rex.

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I realize I should have posted under the nursing student assistance section of this forum and I hope an admin can move my post. But anyway this isn't necessarily homework. I was given several case studies that we will be tested on next week. We were told there are doctor's orders and meds on each case study that we should question. I couldn't find any info online or in books about whether or not the RIPE meds can be given without the AFB results. Since the side effects of these meds can be serious I'm wondering if the AFB results should be in before starting the meds.

I'm not sure why you would refuse to provide your input. It's not like I'm asking for a flat out answer without trying to figure it out myself first.

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Specializes in Complex pedi to LTC/SA & now a manager.

According to this...in most cases wait for culture.

Official American Thoracic Society/Centers for Disease Control and

Prevention/Infectious Diseases Society of America Clinical Practice Guidelines:

Treatment of Drug-Susceptible Tuberculosis | Clinical Infectious Diseases | Oxford Academic

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Specializes in NICU, Infection Control.

This is a valuable resource for health care providers. You should check it out. (in your spare time ;) )

Centers for Disease Control and Prevention

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According to this...in most cases wait for culture.

Official American Thoracic Society/Centers for Disease Control and

Prevention/Infectious Diseases Society of America Clinical Practice Guidelines:

Treatment of Drug-Susceptible Tuberculosis | Clinical Infectious Diseases | Oxford Academic

Thank you! I couldn't find if RIPE was okay to give before AFB results were in.

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This is a valuable resource for health care providers. You should check it out. (in your spare time ;) )

Centers for Disease Control and Prevention

I did check out the CDC website, but nowhere did it say when it was okay to start RIPE. But thanks for trying.

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