Which culture result should a nurse monitor to determine if pyrazinamide might be discontinued?

Monitoring the sputum culture is critical in determining the effectiveness of pyrazinamide in the treatment of tuberculosis (TB), as pyrazinamide is specifically used in combination with other drugs to treat this infection. The sputum culture provides direct evidence of the presence or absence of Mycobacterium tuberculosis in the lungs, which is essential for assessing the patient’s response to the tuberculosis treatment regimen that includes pyrazinamide.

If the sputum culture shows a reduction in or absence of TB bacilli, it may indicate that the treatment is effective, and the healthcare provider may consider discontinuing pyrazinamide as part of the regimen. This is particularly relevant because the goal is to ensure that the patient is no longer infectious and that the treatment is not causing unnecessary side effects or risks when the disease is under control.

Blood cultures, urine cultures, and wound cultures are not directly related to the monitoring of pyrazinamide's effectiveness against TB, as they assess different potential infections and do not give information specific to the response to tuberculosis treatment. Therefore, monitoring the sputum culture directly aligns with evaluating the adequacy of the treatment for tuberculosis, making it the appropriate choice in this context.