nurs 301 STUDENT RESPIRATORY II 2013

Tuberculosis u tb mode of transmission u

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Unformatted text preview: n­ small frequent meals Antibiotic Therapy(finish ABX) Monitor complications Pneumovax and influenza vaccine Tuberculosis (TB) Agent ­ Mycobacterium tuberculosis u Sites of involvement – primarily lung but can involve other body parts u Increased risk for TB if person is immunocompromised u Seen a resurgence of TB – HIV infected pts – Multidrug­Resistant strains of M. tuberculosis u TB Mode of transmission u Spread by airborne droplets u Inhale and set up in alveoli u Multiplies slowly and spreads via lymph system then spreads to other organs/locations Types of TB – – – – – – – – Latent TB (Asymptomatic) (Not active TB) TB in body, fought off by immune system,dormant, no symptoms Cannot spread TB Usually (+) PPD test Normal Chest X ray (­) sputum smear u Active TB – (Symptomatic) u fatigue u weight loss and anorexia u low grade fever u chills u night sweats*** u cough productive may contain blood (advanced) – – Can spread TB to others Abnormal Chest x­ray, (+) PPD, (+) sputum smear Diagnosis of TB u Tuberculin Skin test (TST) – also known as Mantoux test, uses PPD best way to diagnose latentTB – – – u u Occurs 2­12 weeks after infection for (+) result Look for induration 48­72 hours after injection Once positive, don’t do TST again because always + CXR – can’t diagnose using chest x­ray Bacteriologic studies (+ to dx TB) – Test for AFB (acid fast bacilli) u Early morning smears, three days in a row u culture the sputum u QuantiFERON­TB (QFT) – – blood test to check for latent and active TB Results are back within a few hours Nursing Implications for TB u Most TB is treated on an outpatient basis u If hospitalized use airborne isolation u u Active TB Treatment – Four Drug treatment in initial phase because of resistance u Isoniazid (INH) u Rifampin (Rifadin) u Ethambutol (Myambutol) u Pyrazinamide (PZA) – Review TB drugs p 555 Table 28­11 – With INH, PZA and rifampin major side effect: non­viral hepatitis. Monitor liver function – Directly Observed Therapy Latent TB – Isoniazid (INH) (orally daily for 6­9 months) Nursing Care for TB Patients u u Airborne infection isolation – If hospitalized – Negative pressure room – Pt cover mouth tissue, nose when coughing, sneezing then discard – Hand washing – If patient leaves their room need to wear a isolation mask – Masks for hospital personnel u HEPA (High efficiency particulate air) u N95 Need 3 negative sputum smears for acid­fast bacilli, effective response to drug therapy and clinically improving signs to diagnose a patient as noninfectious Obstructive Pulmonary Diseases “When you can’t breathe, nothing else matters.” -American Lung Association Asthma u “Chronic inflammatory disorder of airways” (Kaufman, 2011, p. 588) Chronic inflammation airway → hyperresponsiveness → smooth muscle spasms → limits airflow acutely u Usually reversible u Mucosal edema and thick secretions also block airway u Wheezing, chest tightn...
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This document was uploaded on 03/05/2014 for the course NURS 301 at Liberty University Duplicate School.

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