Tuberculosis Study Module

Front 1

What is TB

Back 1

Airborn disease caused by Mycobacterium tuberculosis, a tubercle acid fast organism

Front 2

Who is at risk for TB

Back 2

Decreased immunity (very old, very young, immuno suppressed, cancer or organ transplant patients

Front 3

Who is at risk for TB

Back 3

prolonged exposure
Nurses working in nursing home, prisoner sharing cell with TP, family member living with TP

Front 4

Who is at risk for TB

Back 4

Persons who are exposed ro virulent strains (drug resistant) client fails to complete prescribed anti-TB drugs

Front 5

Who is at risk for TB

Back 5

Foreign born persons (middle eastern countries) and HCP or persons workign in confined areas (schools, prisons)

Front 6

Latent TB S/S

Back 6

No symptoms
Cannot infect others with TB
Skin test usually positive
Chest x-ray and sputum normal

Front 7

S/s of TB disease

Back 7

Bad cough lasting more than 2 weeks
Chest pain
Coughing up blood or sputum
Weakness or fatigie
Weight loss
no appetite
Chills
Fever
Night sweats

Front 8

TB Disease S/s

Back 8

Can infect others
Skin test positive
abnormal chest x-ray
with or without positive sputum smears or culture for TB

Front 9

Extrapulmonary TB Disease (Miliary TB or Disseminated TB)

Back 9

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.

Front 10

Common Etrapulmonary sites

Back 10

Brain, larynx, lymph nodes, pleura, bone, kidney, lung, spine

Front 11

DX tests

Back 11

Tuberculin skin test (PPD) protein purified derivative. also called the Mantoux test

Front 12

How to read PPD

Back 12

Induration size read 48-72 hrs after administered

Front 13

Other tests to substantiate PPD

Back 13

Sputum smear
Chest e-ray
Sputum culture (2-6 weeks to get thre retsults back) is the most accurate test.

Front 14

Induration of 5+ considered positive for

Back 14

HIV infection
close contact with TB
Previous TB chest x-ray
Illict drug use

Front 15

Induration of 10+ considered positive

Back 15

foreign born
drug use and HIV negative
low income
residential facilities

Front 16

Induration 10+ considered positive

Back 16

diabetic
younger than 4
identified group

Front 17

Induration of 15+ considered positive

Back 17

people with no risk factors for TB

Front 18

Considerations for administration of mantoux test

Back 18

pg may receive test
+ past, + future, screen by questionaire for s/s, yes then chest x-ray and sputum smear

Front 19

2 step mantoux

Back 19

more effective in screening TB because client may have a delayed type hypersesitivity.

Front 20

HCP exposed to pt with TB

Back 20

mantoux test within 8-12 weeks after exposure.

Front 21

BCG (Bacillus Calmette-Guerin)

Back 21

Vaccine to prevent TB
Not always effective
used in foreign countries
TB test prior to vaccine

Front 22

Positive mantoux and no disease treatment

Back 22

6 months of isoniazid (INH) to prevent person from getting the disease

Front 23

Treatment for TB disease

Back 23

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.

Front 24

ISONIAZID (INH)

Back 24

SE: peripheral neuropathy, drug induced hepatitis
Monitor liver profile, s/s of helpatitis and peripheral neuropathy

Front 25

RIFAMPIN

Back 25

SE: Thrombocytopenia, drug drug interactions, flu-like symptoms, harmless orange-stained tears, saliva and urine. Monitor CBC, platelet, bruising, bleeding, photosensitivity

Front 26

ETHAMBUTOL

Back 26

SE: optic neuropathy. Monitor visual acuity, color vision tests

Front 27

PYRAZAMIDE

Back 27

SE: Hyperuricemia. Monitor Serum uric acid level

Front 28

STREPTOMYCIN

Back 28

SE: Ototoxicity, nephrotoxicity. Monitor Serum creatinine, BUN, audiometry for s/s of ototoxicity.

Front 29

Drug Resistant Organisms

Back 29

Caused by client non-adherence to prescribed treatment

Front 30

HIV clients

Back 30

9 months minimal and ultil sputum has convered to negative for at least 6 months

Front 31

s/s of TB

Back 31

persistent cough
bloody sputum
weight loss
fever
night sweats

Front 32

TB Isolation rooms

Back 32

6-10 negative air exchanges per hour
door to room shut to maintain negative pressure

Front 33

Precautions

Back 33

airborne precautions, posted on door to room, visitors should see nurse before seeing pt.

Front 34

Nursing DX

Back 34

Knowledge deficit
Airway clearance
Fear and isolation

Front 35

Nursing Interventions for TB patient

Back 35

TCDB, fluids to liquify secretions, oral care, small frequent meals, assess respiratory status and VS, use masks and handwashing, negative air exhcange

Front 36

Collecting sputum samples

Back 36

Rish mouth, deep breath 3 times, discard 1st sample, use second sample in sterile container

Front 37

Complance Essentials

Back 37

therapeutic relationship
DOT
Referal
Incorporate tx into daily life

Front 38

Teaching

Back 38

take meds as prescribed
Notify HCP if out of meds
Keep FU visits
cover mouth

Front 39

Attending school or work

Back 39

not until approved by HCP. 2-3 weeks and 3 negative sputum smears to be considered noncontagious.

Front 40

When is TB person considered non contagious

Back 40

3 negative sputum spears

Front 41

TB at home

Back 41

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.

Front 42

Rifampin

Back 42

turns saliva, tears, and urine orange, oral contraceptives less effective

Front 43

Who needs to be contacted by the health departmetn for possible TB exposure?

Back 43

Everyone pt has been in contact with over the last 3 months.

Front 44

Techniquest to obtain sputum sample

Back 44

induced, bronchoscopy or gastric washing