To ensure rifampin is not contraindicated, the nurse should confirm the patient does not have which condition?

To ensure rifampin is not contraindicated, the nurse should confirm the patient does not have which condition?

• A. Hepatic impairment
• B. Diabetes mellitus
• C. HIV infection
• D. Renal impairment

Answer: (D)

Rifampin is processed by the liver and has a real risk of causing liver injury, so the key safety check is liver function. Before starting rifampin, the nurse should verify that the patient does not have hepatic impairment or significant liver disease, because existing liver problems can lead to severe hepatotoxicity or rapid drug accumulation. Signs to watch for include jaundice, unusual fatigue, dark urine, or elevated liver enzymes on prior tests. Renal impairment is not a major contraindication for rifampin, since the drug is largely metabolized by the liver and excreted in bile, not predominantly by the kidneys. Diabetes mellitus and HIV infection are not contraindications either, though rifampin can interact with certain diabetes medications and antiretroviral therapies, so monitoring for interactions is important. The essential precaution remains ensuring the patient has adequate hepatic function before beginning therapy.

Rifampin is processed by the liver and has a real risk of causing liver injury, so the key safety check is liver function. Before starting rifampin, the nurse should verify that the patient does not have hepatic impairment or significant liver disease, because existing liver problems can lead to severe hepatotoxicity or rapid drug accumulation. Signs to watch for include jaundice, unusual fatigue, dark urine, or elevated liver enzymes on prior tests.

Renal impairment is not a major contraindication for rifampin, since the drug is largely metabolized by the liver and excreted in bile, not predominantly by the kidneys. Diabetes mellitus and HIV infection are not contraindications either, though rifampin can interact with certain diabetes medications and antiretroviral therapies, so monitoring for interactions is important. The essential precaution remains ensuring the patient has adequate hepatic function before beginning therapy.