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27 Cards in this Set
- Front
- Back
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PEOPLE AT RISK FOR TB
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-ELDERLY
-FOREIGN BORN + CROWDED CONDITIONS -HIV -AFRICAN AMERICAN -HOMELESS -DRUG USERS |
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TB INFECTION
-HOW IS IT DETECTED? |
BACILLUS HAS ESTABLISHED ITSELF IN THE BODY
-CAN BE DETECTED BY A POSITIVE SKIN TEST |
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TB DISEASE
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BACILLUS CAN BE ISOLATED FROM SECRETIONS OR LUNG TISSUE
-CXR OR CLINICAL S/S |
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ETHAMBUTOL (MYAMBUTOL)
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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 |
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PERIPHERAL NEURITIS
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NUMBNESS IN TOES
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IS TB HIGHLY CONTAGIOUS?
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NO, YOU MUST BE A HIGHLY SUSCEPTIBLE HOST IN ORDER TO GET TB
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TB (TUBERCULOSIS BACILLUS)
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-AEROBIC
-ACID FAST -AFB |
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PYRAZINAMIDE (PZA,ZINAMIDE)
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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 |
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WHAT IS THE DRUG COURSE OF THERAPY FOR TB?
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1ST 2 MONTHS: ISONIAID,RIFAMPIN,PYRAZINAMIDE,ETHAMBUTOL
FOR ANOTHER 4 MONTHS:ISONIAID,RIFAMPIN **6 MONTHS TOTAL** |
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ISONIAZID (INH)
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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 |
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RIFAMPIN (RIFADIN)
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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) |
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WHAT PT HISTORY SHOULD U GET FOR TB
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-KNOWN EXPOSURE
-AT RISK=HIV + REPORT VAGUE SYMPTOMS: 1.COUGH OF 3 WKS 2.NIGHT SWEATS 3.HORSENESS 4.WT LOSS, ANOREXIA |
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SKIN TEST
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**MANTOUX TEST**
-PPD -48 TO 72 HRS READ |
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WHAT DOES NURSE LOOK FOR IN A TB TEST
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-HARDNESS
-INDURATION OF 10MM OR MORE -A SIGNIFICANT RXN CLOSE CONTACT 5-9 MM IS SIGNIFICANT |
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REACTION IS SUPPRESSED W/
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RECENT VIRAL INFECTION
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IF A PT IS HIV+ OR ON CORTICOSTERIODS,PT WILL BE_
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INJECTED WITH MUMPS AND RXN TESTED
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SPUTUM TEST
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-AFB
-ONLY CONFIRMATIVE TEST -3 (AM) SPECIMENS -SMEAR 24 HR -CULTURE 2-12 WKS (10-14 DAYS RAPID) |
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WHAT DOES NURSE LOOK FOR IN CXR- CHEST X RAY?
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NURSE LOOKS FOR BLACK DOTS
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SYMPTOMATIC TXT
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EVERY DAY NUTRITION HEALTH TEACHING
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BCG VACCINE
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-BACILLI CALMETTI GUERIN
-EFFECTIVENESS IS BETWEEN 0-80 PERCENT -USED TO PREVENT TB -FOUND UNRELIABLE -SEEN IN EUROPEAN COUNTRIES |
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COMPLICATIONS OF TB
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**DRUG RESISTANT TB**
-IN PRISON POPULATION/HIV + DUE TO NONCOMPLIANCE |
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DOT THERAPY
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DIRECTLY OBSERVED THERAPY
-TB PERSON IS FOLLOWED BY HEALTH DEPT |
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TB NURSING DIAGNOSIS
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-KNOWLEGE DEFICIT
-IMPAIRED GAS EXCHANGE -ALTERATION IN NUTRITION -SOCIAL ISOLATION -NON COMPLIANCE |
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TXT OF TB
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-RELIEF OF SYMPTOMS
-ADHERENCE TO TXT REGIMEN |
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DRUG THERAPY
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-RAPID REDUCTION IN # OF TB CELLS
-TXT LONG ENOUGH TO ELIMINATE PERSISTANT ORGANISMS -COMBINATION OF 3-4 DRUGS: FOR 6 MONTHS |
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PREVENTATIVE THERAPY FOR TB
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INH 6-12 MOS FOR RECENT PPD CONVERTER
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INFECTION CONTROL FOR TB
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-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 |
