Improving access to health care and education ii Acute care 1 Pt suspected of

Improving access to health care and education ii

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Improving access to health care and educationii.Acute care1.Pt suspected of having TBa.Placed on airborne isolation - High-efficiency particulate air (HEPA) masks must be worn when working with this ptb.Receive medical workup includingi.Chest x-rayii.Sputum culturec.Receive appropriate drug therapyd.Teach to cover nose and mouth when sneezing, coughing, or producing sputum and throw tissues into paper bag and then flush or throw in garbage.e.If pt does have TB, screen people close to them in their life that may also have contracted it.iii.Ambulatory care1.Pt is discharged to home when responding well to treatment, even if they still have positive cultures (still contagious).2.Cultures done every month until 3 negative culture prove pt no longer contagious.3.Teach pt to minimize spread.a.Well-ventilate houseb.Sleep alone while infectiousc.Spend time outdoorsd.Minimize time in public settings4.Teach strict adherence to medication regimen and drug teaching (see above).5.Teach recognition of relapse symptoms and which factors might trigger reactivation (see above).6.Encourage smoking cessation.i.Complications (TB)i.When appropriately treated, TB will heal with few complications, but can cause scarring and residual cavitation in lungs.ii.Significant pulmonary damage can occur in those who are undertreated.iii.Miliary TB 1.Bacteria spreads throughout the body23
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2.Fatal if untreated3.Symptoms vary based on which organs are affected, but can includeiv.Pleural TB - bacteria enter pleural space and fluid accumulates causing pleural effusionv.Pott’s disease - TB in the spinevi.Severe bacterial meningitis if TB enters nervous systemvii.Peritonitis - TB in abdominal cavity9.Chronic obstructive pulmonary disorder (COPD)a.USED TO be defined as the coexistence of two diseasesi.Emphysema- pathologic destruction of alveoliii.Chronic bronchitis- cough and sputum production for at least 3 months during 2 consecutive yearsb.Current definition: progressive respiratory disease characterized by persistent airflow obstruction and chronic inflammation, often related to cigarette smokingc.Risk factors (COPD)i.Cigarette smoking is biggest risk.ii.Occupational chemicals and dustsiii.Air pollutioniv.Infection - severe recurring resp infections in childhood, HIV infectionv.Genetics - alpha1-antitrypsin (AAT) deficiency that reduces protective enzymes in lungsvi.Agingvii.Asthmaviii.Gender - currently more males, but incidence in women is increasingd.Pathophysiology (COPD)i.Inflammation1.Noxious particles and gases, such as from cigarettes, trigger an immune response.2.Neutrophils, macrophages, and lymphocytes are main cells involved.3.Inflammatory mediators (leukotrienes, cytokines) are attracted to scene.
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