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27 Cards in this Set

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PEOPLE AT RISK FOR TB
-ELDERLY
-FOREIGN BORN + CROWDED CONDITIONS
-HIV
-AFRICAN AMERICAN
-HOMELESS
-DRUG USERS
TB INFECTION
-HOW IS IT DETECTED?
BACILLUS HAS ESTABLISHED ITSELF IN THE BODY
-CAN BE DETECTED BY A POSITIVE SKIN TEST
TB DISEASE
BACILLUS CAN BE ISOLATED FROM SECRETIONS OR LUNG TISSUE
-CXR OR CLINICAL S/S
ETHAMBUTOL (MYAMBUTOL)
DOSE:15MG/KG IN A SINGLE DOSE EACH DAY
ACTION:BACTERIOSTATIC
S/E: OPTIC NEURITIS,GI DISTRESS,LIVER,INCREASED URIC ACID
NURSING:TAKE AS A SINGLE DOSE EACH DAY
PERIPHERAL NEURITIS
NUMBNESS IN TOES
IS TB HIGHLY CONTAGIOUS?
NO, YOU MUST BE A HIGHLY SUSCEPTIBLE HOST IN ORDER TO GET TB
TB (TUBERCULOSIS BACILLUS)
-AEROBIC
-ACID FAST
-AFB
PYRAZINAMIDE (PZA,ZINAMIDE)
DOSE:3 GRAMS/DAY DIVIDED INTO 3-4 DOSES
ACTION:BACTERIOCIDAL
S/E:HEPATOTOXICITY,INCREASED URIC ACID,CAREFUL USE W/ DIABETES
NURSING:INCREASE FLUIDS TO 2L/DAT
WHAT IS THE DRUG COURSE OF THERAPY FOR TB?
1ST 2 MONTHS: ISONIAID,RIFAMPIN,PYRAZINAMIDE,ETHAMBUTOL
FOR ANOTHER 4 MONTHS:ISONIAID,RIFAMPIN
**6 MONTHS TOTAL**
ISONIAZID (INH)
DOSE:300 MG/DAY
ACTION:BACTERIOCIDAL
S/E:PERIPHERAL NEURITIS,REVERSIBLE HEPATOXICITY (INCREASES W/ AGE)
NURSING:VIT B6(PYRIDOXINE)25-50MG/DAY FOR PERIPHERAL NEURITIS,MONITOR LIVER FCN
RIFAMPIN (RIFADIN)
DOSE:600 MG/DAY
ACTION:BACTERIOCIDAL
S/E:GI DISTRESS,LIVER,MENTAL CONFUSION,ORANGE/REDDISH BODY SECRETIONS,INACTIVATES BIRTH CONTROL PILLS
NURSING:TAKE AT HS (NIGHTTIME)
WHAT PT HISTORY SHOULD U GET FOR TB
-KNOWN EXPOSURE
-AT RISK=HIV +
REPORT VAGUE SYMPTOMS:
1.COUGH OF 3 WKS
2.NIGHT SWEATS
3.HORSENESS
4.WT LOSS, ANOREXIA
SKIN TEST
**MANTOUX TEST**
-PPD
-48 TO 72 HRS READ
WHAT DOES NURSE LOOK FOR IN A TB TEST
-HARDNESS
-INDURATION OF 10MM OR MORE
-A SIGNIFICANT RXN
CLOSE CONTACT 5-9 MM IS SIGNIFICANT
REACTION IS SUPPRESSED W/
RECENT VIRAL INFECTION
IF A PT IS HIV+ OR ON CORTICOSTERIODS,PT WILL BE_
INJECTED WITH MUMPS AND RXN TESTED
SPUTUM TEST
-AFB
-ONLY CONFIRMATIVE TEST
-3 (AM) SPECIMENS
-SMEAR 24 HR
-CULTURE 2-12 WKS (10-14 DAYS RAPID)
WHAT DOES NURSE LOOK FOR IN CXR- CHEST X RAY?
NURSE LOOKS FOR BLACK DOTS
SYMPTOMATIC TXT
EVERY DAY NUTRITION HEALTH TEACHING
BCG VACCINE
-BACILLI CALMETTI GUERIN
-EFFECTIVENESS IS BETWEEN 0-80 PERCENT
-USED TO PREVENT TB
-FOUND UNRELIABLE
-SEEN IN EUROPEAN COUNTRIES
COMPLICATIONS OF TB
**DRUG RESISTANT TB**
-IN PRISON POPULATION/HIV +
DUE TO NONCOMPLIANCE
DOT THERAPY
DIRECTLY OBSERVED THERAPY
-TB PERSON IS FOLLOWED BY HEALTH DEPT
TB NURSING DIAGNOSIS
-KNOWLEGE DEFICIT
-IMPAIRED GAS EXCHANGE
-ALTERATION IN NUTRITION
-SOCIAL ISOLATION
-NON COMPLIANCE
TXT OF TB
-RELIEF OF SYMPTOMS
-ADHERENCE TO TXT REGIMEN
DRUG THERAPY
-RAPID REDUCTION IN # OF TB CELLS
-TXT LONG ENOUGH TO ELIMINATE PERSISTANT ORGANISMS
-COMBINATION OF 3-4 DRUGS: FOR 6 MONTHS
PREVENTATIVE THERAPY FOR TB
INH 6-12 MOS FOR RECENT PPD CONVERTER
INFECTION CONTROL FOR TB
-AIRBORNE PRECAUTIONS
-RESPIRATOR(NEEDS TO FIT)
-D'C PRECAUTIONS AFTER 2-3 WKS OF TXT
-UV LIGHT
-NEGATIVE PRESSURE (6 AIR EXCHANGE/HR)
-SPUTUM C+S EVERY 2-4 WKS
-WATCH(FOMITE)
-PT WEARS RESPIRATOR IF BEING DC