TB Flashcards
What type of precaution is used for TB?
What does this involve?
- airborne precautions
- N95 respirator or better, neg pressure room, pt should wear a mask if out of the room
- any other PPE can be added so we can meet the needs of the pt and protect ourselves (ie : eye pro)
At what point does cell mediated immunity develop?
Why is this important?
- develops 2-12 weeks after initial infection
- this is when we can test and get a positive result
Is it more common to have an INITIAL development of active or latent TB?
latent
A pt has latent TB :
- Where is the bacteria? is it dividing?
- is the pt symptomatic?
- is the pt contagious?
- should we tx this pt for TB?
- the bacteria is in a granuloma (walled off / secluded) in the lung and is dormant (no division)
- no sx
- not contagious
- it is best practice to treat this pt for TB (not everyone does this)
Who is at risk for contracting TB? (8)
- ppl with repeated expose to active / untx TB
- immunocomp
- live in crowded area
- homeless
- IV drug users
- alcoholics
- foreign migrants
- low socioeconomic
Why might the INITIAL treatment (before cultures are complete) be different for someone who contracted TB in South Africa vs the US?
- initial treatment is based on the immune system of the pt and patterns of drug resistance in the community
What are 6 sx that are commonly associated with TB?
- productive blood tinged cough
- fatigue
- anorexia –> weight loss
- night sweats : different from other viral infections, same as menopause
- fever : low grade in afternoon
- adventitious breath sounds : maybe
What things should you consider when completing a psychosocial assessment for a pt who is being treated for TB?
- isolation : mental, physical, ability to do this
- support
- ability to cope
- ability to adhere to drug regimen
- current living situation
What are the 2 tests to SCREEN for TB?
What are they screening for?
- PPD skin test
- Blood tests : quantiferon gold & T-spot
- screening for Antibodies
Explain how to read a PPD skin test :
What are you looking for?
What are the 3 population groups?
- looking for induration : more than just redness - nodule
- general public w/o risk factors : >15 mm
- residents at long term care facility, IV drug users, medically underserved population, health care workers : >10 mm
- 3 . HIV pos or recent close contact with active TB : > 5 mm
A positive PPD test is indicating the ability to ________?
This test would not be helpful in what type of pts?
- indicated the ability to mount an immune response
- would not be useful in immunocomp pts, esp HIv pos
What test is used to confirm a pos TB case and determine when the pt is no longer infective?
- sputum culture
- need 3 negative cultures to be considered negative
What test is used to determine drug resistance and used in HIV pts?
X-Pert MTB/FIB : blood test
** a sputum culture and sensitivity test could also do this ??
What interventions are used for pts with TB? (9)
- facilitate breathing / O2 : Turn up or put on
- hydration
- pulmonary hygiene
- incentive spirometer
- manage anxiety
- nutrition
- case management
- dec / eliminate EtOH use
- infection prevention
The medication regimen for TB is difficult to maintain, what are things done to help promote adherence? (4)
- DOT : direct observed therapy
- intermittent dosing
- combo drug therapy
- support and resources
