PTB Flashcards
it is used to identify pathogenic organisms and to determine whether malignant cells are present
SPUTUM STUDIES
what is the usual method of obtaining a sputum sample?
Expectoration
When obtaining a sputum sample, a nurse should instruct the patient to
Inhale and deplate
to get the sputum at the base of the lungs
best time to obtain sputum sample
early in the morning
the microoganisms accumulate overnight
Sputum specimen should be delivered to the lab within ____
2 hours
to prevent overgrowth of microorganisms
TWO TYPES OF TUBERCULOSIS
- Pulmonary Tuberculosis
- Extrapulmonary Tuberculosis
The nurse offers _______ after the collection of specimen in sputum studies.
oral hygiene
provide comfort
TB causative agents
- Mycobacterium tuberculosis
- Mycobacterium Africanum
- Mycobacterium bovis
TB among children is called ______
Primary Complex
4 mode of transmissions of TB
( A-D-D-I )
Airborne, Droplet, Direct invasion, Ingestion of unpasteurized milk or dairy products
To prevent the transmission of airborne microoorganisms, nurse x must wear ____.
N95/well fitted respirator mask
transmission of smaller particles/microrganism
Airborne
transmission of bigger particles/microrganism
Droplet
It is a rare mode of transmission where in a person must wear gloves, mask, and gown as precautionary measures. Nurses must leave the PPE’s in the patient room before going out.
Direct invasion
what are the extreme temperatures to destroy microorganisms
63° C in 30 mins and 71.6° C degrees in 15 secs
Incubation Period of TB
2-8 weeks
How long must a patient adhere to the pTB regimen in order to become non-contagious?
2-4 weeks
patients/ people under CLOSED CONTACTS are
those who stayed in an ENCLOSED SPACE FOR 3 MONTHS
patients/ people under HIGH RISK GROUP are
those who stayed in a CLOSED ENVIRONMENT (prison/inmates)
patients/ people under HIGH RISK CLINICAL GROUP are
Patients with AIDS, HIV, DM, Renal Failure
(immunocompromised)
6 CARDINAL SIGNS of PULMONARY TB
( P-H-L-A-W-N)
Persistent Cough
Hemoptysis
Low Grade Fever ( in the afternoon)
Anorexia
Weight Loss
Night Sweats
what are the three Dx Tests for pTB?
( D-C-T )
- Direct Sputum Smear Microscopy (DSSM)
- Chest X-ray
- Tuberculin Skin Test
What will you instruct to a patient when applying the SPOT/Conventional Therapy
Ask the patient to go back early in the morning to collect his/her sputum
when will you obtain the sputum sample when applying the “SPOT-SPOT” method ?
1ST SPOT: Collect after the chief complaint/ on the spot
2ND SPOT: After 1 hour
3RD SPOT: Early in the next morning
. Tuberculin Skin Test:
+10 mm means?
Exposed patients/Positive pTB
Tuberculin Skin Test:
+5 mm means?
immunocompromised patients (AIDS,HIV patients)/Positive pTB
A patient that is NOT yet diagnosed/with TB before & taking TB drugs for 2 months is classified as ?
new TB
After receiving treatment for her TB, patient C was rediagnosed with the illness, which is categorized as?
Relapse patients
The TB treatment for Patient A was unsuccessful. This is categorized as?
Treatment after failure patients
RETURN AFTER DEFAULT; loss of contact/follow-up for 2 months is classified as?
Treatment after loss to follow-up patients
The man has no known treatment/undocumented TB treatment is identified to be marked as ?
Other previously treated patients
Patient K does not fit in any category under classification of previous TB treatment is marked as ?
Patients with unknown previous TB treatment history
DOTS- Directly Observed Treatment Short Course is done in ______
health center/clinic
How long is the Intensive Phase of DOTS
2 months
How long is the Maintenance Phase of DOTS
4 months
First Line of drugs in PTB
Rifampicin , Izoniazid, Pyrazinamide, Ethambutol, Streptomycin
What are the two classes of second line drugs in PTB?
Amino glycosides and Fluoroquinolones
Multi-drug Therapy is applied in PTB treatment to?
To reduce resistance particulary to Isoniazid & Rifampicin
the nurse knows that she will discontinue administering RIPE drugs to PTB patient if she observes:
Jaundice
discontinue administering ethambutol if the patient portrays
Visual impairment
Tinnitus and hearing impairment are caused by what drug under the PTB Multi-drug Therapy?
Streptomycin
Oliguria and albuminuria are caused by what drug under the PTB Multi-drug Therapy?
Streptomycin & Rifampicin
Isoniazid can cause ?
Psychosis and convulsion
Thrombocytopenia and anemia are caused by what drug under the PTB Multi-drug Therapy?
Rifampicin
Multiple Drug Resistance TB (MDR-TB) means ?
Resistant to Isoniazid and Rifampicin
Extensively Drug Resistance TB (XDR-TB) is resistant to what drug/s?
Isoniazid, Rifampicin, and Fluoroquinolones
Extremely Drug Resistance TB (XXDR-TB) is resistant to what drug/s?
Resistant to Isoniazid, Rifampicin, and Fluoroquinolones
Total Drug Resistance TB (TDR-TB) is resistant to what drug/s?
Resistant to Isoniazid, Rifampicin, and Fluoroquinolones
It is a diagnostic procedure that detects fluids, tumors, foreign bodies and other pathologic conditions
CHEST X-RAY
Side effect of Rifampicin
Red-orange urine/secretions
What vitamin will you give for a patient taking Izoniazid?
Vitamin B6
Streptomycin is contraindicated to Pott’s dse because?
It can damage the Cranial Nerve VIII
Do we offer mouthwash before taking specimen/sputum?
No, water only
mouthwash kills the microorganisms and may lead to innacurate results
Two Sputum: Positive
Positive pTB
Two Sputum: One negative, One positive
Obtain Chest X-ray
How many hours will you wait for the 2nd spot in SPOT-SPOT??
1 hr
mm: HIV
5 mm
drugs listed under C1, intensive phase
2HRZE (Isoniazid, Rifampicin, Pyrazinamide, Ethambutol)
drugs listed under C1, maintenance phase
4HR (Isoniazid, Rifampicin )
drugs listed under C2, maintenance phase
5HRE (Isoniazid, Rifampicin, Ethambutol)
drugs listed under C2, intensive phase
2HRZES (Isoniazid, Rifampicin, Pyrazinamide,Ethambutol,Streptomycin)
patients classified as : New pTB, Extensive Parenchyma Lesions are under the category treatment of ?
( C1, C2, C3 or C4)
C1
patients classified as : Relapse, Treatment failure, return after default,and others are under the category treatment of ?
( C1, C2, C3 or C4)
C2
patients classified as : New pTB; with minimal lesions are under the category treatment of ?
( C1, C2, C3 or C4)
C3
patients classified as : Chronic pTB; Positive TB after supervise treatment , are under the category treatment of ?
( C1, C2, C3 or C4)
C4
drugs under C3, Intensive Phase are?
2HRZ (Isoniazid, Rifampicin, Pyrazinamide)
drugs under C3, maintenance phase are ?
4HR (Isoniazid,Rifampicin)
Amikacin, Kanamycin, and Capreomycin are drugs under?
Second line: Amino glycosides
Ciprofloxacin, Moxifloxacin amd Levofloxacin are drugs under?
Second line: Fluoroquinolones
it is an airway clearance technique (ACT) to clear the lungs
CHEST PHYSIOTHERAPY
the main goal of performing the chest physiotherapy is to ___?
to remove
tracheobronchial secretions
how long do we perform the Chest Physiotherapy?
20-40 MINUTES
what is the best time to perform chest physiotherapy?
- Upon awakening
- Before meals
- 30 mins to 2hrs after meals; to prevent aspiration
- At bed time ; to prevent sleep disturbance.
are we allowed to perform CPT on bare skin?
No
CPT is done in patients with Airbone Infections. True / false?
false
increases the risks for transmision of microorganisms
what kind of clothes are allowed for the patient to wear in CPT?
Light, soft clothing, such as a T-shirt
The patient can wear tight clothing, jewelry, buttons, and
zippers around the neck, chest and waist during CPT. True or False?
False
no tight clothing, jewelry,buttons,zippers around neck, waist and chest
Classifications of CPT
- Postural Drainage
- Percussion
- Vibration
it involves positioning a person with the assistance of gravity to aid the normal airway clearance mechanism
Postural Drainage
Length of time to hold Positions under postural drainage
3-15 minutes
Positions under Postural Drainage?
Sitting, Trendelenburg, Prone,Side-lying
This position includes placing a small pillow under head, 2 pillows under bent knees.
Trendelenburg
This position includes putting 2 or 3 pillows under stomach so that chest is lower than hips.
Prone
This position includes placing a small pillow under head and 2 or 3 pillows under hips
Side-lying
Under postural drainage, what breathing technique must be instructed to the patient ?
Breathe in through nose and out through mouth.Always breathe out for longer than breathe in.
This allows lungs to empty as much as possible.
This is accomplished by rhythmically striking the thorax/chest wall with a cupped hand or mechanical device directly over the lung segment(s) being drained. Also referred to as cupping, clapping, and tapotement
Percussion
How long do we perform percussion?
2-3 mins; maximum 5 mins
Special attention must be taken to not clap over the:
- Spine, Breastbone, Stomach
- Lower ribs or back
1. may cause fracture
2. May cause damage to spleen, kidneys , liver
it involves the application of a fine tremorous action/ rapid vibratory impulse is transmitted through the chest wall from the flattened hands to loosen and dislodge the airway secretions
Vibration
how long do we perform vibration under the CPT?
15 seconds