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44 Cards in this Set

  • Front
  • Back
What is TB
Airborn disease caused by Mycobacterium tuberculosis, a tubercle acid fast organism
Who is at risk for TB
Decreased immunity (very old, very young, immuno suppressed, cancer or organ transplant patients
Who is at risk for TB
prolonged exposure
Nurses working in nursing home, prisoner sharing cell with TP, family member living with TP
Who is at risk for TB
Persons who are exposed ro virulent strains (drug resistant) client fails to complete prescribed anti-TB drugs
Who is at risk for TB
Foreign born persons (middle eastern countries) and HCP or persons workign in confined areas (schools, prisons)
Latent TB S/S
No symptoms
Cannot infect others with TB
Skin test usually positive
Chest x-ray and sputum normal
S/s of TB disease
Bad cough lasting more than 2 weeks
Chest pain
Coughing up blood or sputum
Weakness or fatigie
Weight loss
no appetite
Night sweats
TB Disease S/s
Can infect others
Skin test positive
abnormal chest x-ray
with or without positive sputum smears or culture for TB
Extrapulmonary TB Disease (Miliary TB or Disseminated TB)
Not infectious to other
Damages to tissues and organs that TB travels to
Can be treated with Anti-TB drugs and supportive care for the organ damage that has already occurred.
Common Etrapulmonary sites
Brain, larynx, lymph nodes, pleura, bone, kidney, lung, spine
DX tests
Tuberculin skin test (PPD) protein purified derivative. also called the Mantoux test
How to read PPD
Induration size read 48-72 hrs after administered
Other tests to substantiate PPD
Sputum smear
Chest e-ray
Sputum culture (2-6 weeks to get thre retsults back) is the most accurate test.
Induration of 5+ considered positive for
HIV infection
close contact with TB
Previous TB chest x-ray
Illict drug use
Induration of 10+ considered positive
foreign born
drug use and HIV negative
low income
residential facilities
Induration 10+ considered positive
younger than 4
identified group
Induration of 15+ considered positive
people with no risk factors for TB
Considerations for administration of mantoux test
pg may receive test
+ past, + future, screen by questionaire for s/s, yes then chest x-ray and sputum smear
2 step mantoux
more effective in screening TB because client may have a delayed type hypersesitivity.
HCP exposed to pt with TB
mantoux test within 8-12 weeks after exposure.
BCG (Bacillus Calmette-Guerin)
Vaccine to prevent TB
Not always effective
used in foreign countries
TB test prior to vaccine
Positive mantoux and no disease treatment
6 months of isoniazid (INH) to prevent person from getting the disease
Treatment for TB disease
4 drugs becasue it takes 3-6 weeks for culture results to become available.Once drug sensitivity is determined the HCP may choose to prescribe only the anti-TB drug that the organism is sensitive to.
SE: peripheral neuropathy, drug induced hepatitis
Monitor liver profile, s/s of helpatitis and peripheral neuropathy
SE: Thrombocytopenia, drug drug interactions, flu-like symptoms, harmless orange-stained tears, saliva and urine. Monitor CBC, platelet, bruising, bleeding, photosensitivity
SE: optic neuropathy. Monitor visual acuity, color vision tests
SE: Hyperuricemia. Monitor Serum uric acid level
SE: Ototoxicity, nephrotoxicity. Monitor Serum creatinine, BUN, audiometry for s/s of ototoxicity.
Drug Resistant Organisms
Caused by client non-adherence to prescribed treatment
HIV clients
9 months minimal and ultil sputum has convered to negative for at least 6 months
s/s of TB
persistent cough
bloody sputum
weight loss
night sweats
TB Isolation rooms
6-10 negative air exchanges per hour
door to room shut to maintain negative pressure
airborne precautions, posted on door to room, visitors should see nurse before seeing pt.
Nursing DX
Knowledge deficit
Airway clearance
Fear and isolation
Nursing Interventions for TB patient
TCDB, fluids to liquify secretions, oral care, small frequent meals, assess respiratory status and VS, use masks and handwashing, negative air exhcange
Collecting sputum samples
Rish mouth, deep breath 3 times, discard 1st sample, use second sample in sterile container
Complance Essentials
therapeutic relationship
Incorporate tx into daily life
take meds as prescribed
Notify HCP if out of meds
Keep FU visits
cover mouth
Attending school or work
not until approved by HCP. 2-3 weeks and 3 negative sputum smears to be considered noncontagious.
When is TB person considered non contagious
3 negative sputum spears
TB at home
bedrrom far from family with open window and fan exhaust.
Avoid close personal contact
Report all contacts within past 3 months to board of health for follow up.
turns saliva, tears, and urine orange, oral contraceptives less effective
Who needs to be contacted by the health departmetn for possible TB exposure?
Everyone pt has been in contact with over the last 3 months.
Techniquest to obtain sputum sample
induced, bronchoscopy or gastric washing