TB

Question 1

immunocompromised, HIV or AIDS, crowded places (dormitory, nursing home, etc), alcohol addiction, any condition than makes you more immunocompromised

Answer 1

risk factors for TB

Question 2

droplet nuclei containing tuberculosis bacilli are inhaled and enters the lungs where it travels to the ______, the bacilli multiply in the alveoli and then a small number enter the blood stream and start affection other areas of the body BRAIN, LARYNX, LYMPH NODES, LUNGS, SPINE, BONE , KIDNEYS. these organs and areas are affected too

Answer 2

alveoli

Question 3

Infectious disease that primarily affects the lung parenchyma
May be transmitted to any organ through the blood (meninges, kidneys, bones and lymph nodes)
Primary infectious agent = Myobacterium tuberculosis
acid fast aerobic rod
grows slow, sensitive to heat and UV light

Answer 3

Tuberculosis

Question 4

after its been in the blood for 2 to 8 weeks, macrophages will ingest and surround the bacteria, macrophages will develop a barrier shell called a ______ and prevents the BACTERIA FROM MULTIPLYING, THIS IS LATENT TB. if macrophages cant keep it under control, the TB will spread

Answer 4

granuloma

Question 5

: will have a small amount of TB bacteria in body that are alive, but inactive. does not feel sick, does not have symptoms. can become sick though if their immune system becomes compromised.

Answer 5

LATENT

Question 6

: large amount of TB in body and is _____. will feel sick.

Answer 6

active TB

Question 7

will have a normal chest X ray, will have a negative sputum culture. may be treated prophylactic. is not on respiratory isolation. A person with latent TB case will not be identified as a TB case, a positive skin test will be reported but from there it is the Health Department that will decide about classification.

Answer 7

latent

Question 8

will have an x ray that shows up. will definitely be treated. will be on respiratory isolation.

Answer 8

Active:

Question 9

In frequent and close contact with an untreated individual
Who are immunocompromised (HIV, chemo)
Living in crowded facilities (prisons, long term care)
From a lower socioeconomic status
Who are homeless
Who are immigrants from countries with a high incidence of TB

Answer 9

common risk factors for TB

Question 10

Low grade fever, cough, night sweats, fatigue and weight loss
Cough
Non-productive
Mucopurulent sputum may be expectorated
Both systemic and pulmonary symptoms are chronic
May be present for weeks to months

Answer 10

s/s of tb

Question 11

_________ are like a distinguishing thing about TB apparently

Answer 11

NIGHT SWEATs

Question 12

progressive fatigue
malaise
anorexia
weight loss
chronic cough (productive)
nigh sweats
hemoptysis
pleuritic chest pain
low grade temp

Answer 12

s/s of tb

Question 13

Usually present with less pronounced symptoms than younger patients
May have unusual behavior and altered mental status, fever, anorexia and weight loss
Often the ______ will produce no reaction

Answer 13

TB skin test

Question 14

extraplumonary disease is seen in up to 16% of cases in the US and is where the disease is seen in other areas of the body. this is mostly seen in?

Answer 14

AIDS patients

Question 15

Complete health history
healthcare worker, travel, crowded conditions
Physical examination
Tuberculin skin test
Chest x-ray
Acid-fast bacillus smear
Sputum culture

Answer 15

diagnostic tools for TB

Question 16

A TB skin test is also known as a ____ test but there is also a faster _____ test

Answer 16

Mantoux, nucleic acid amplification test

Question 17

Chest x-ray usually reveals lesions in the upper lobes
Acid-fast bacillus smear contains mycobacteria
Fever, anorexia, weight loss, night sweats, fatigue, cough and sputum production
If the above are present, assess lungs for consolidation by evaluating breath sounds, fremitus and egophony

Answer 17

for a patient with active TB

Question 18

Mantoux method
Used to determine whether the person has been infected with the TB bacillus
Intracutaneous injection using PPD (purified protein derivative) into the intradermal layer of the inner aspect of the forearm using a tuberculin syringe
Dose = _____
Test is read ______ hours after administration

Answer 18

0.1ml, 48-72

Question 19

A positive reaction occurs when both _____ and ____ are present

Answer 19

erythema and induration

Question 20

t/f: Erythema without induration is not significant

Answer 20

true

Question 21

Enzyme-linked immunosorbent assay (ELISA) that detects the release of interferon-gamma by white blood cells when the blood of the patient with TB is incubated with peptides similar to those in M. tuberculosis
Indicates whether the person has been infected, NOT whether or not the person has active progression of the disease

Answer 21

QuantiFERON-TB Gold Test

Question 22

Antituberculosis agents for ______ months

Answer 22

6-12

Question 23

Promoting Airway Clearance
Advocating Treatment Regimen
Promoting Activity and Nutrition
Preventing Transmission

Answer 23

nursing management for TB

Question 24

Of the approved drugs, INH, RIF, EMB, and PZA are considered the ______ anti-TB drugs and form the core of standard treatment regimens.

Answer 24

first-line

Question 25

___ month treatment plan is most common

Answer 25

six

Question 26

What foods do you need to avoid if youre taking INH?

Answer 26

tyramine

Question 27

What are the common first line treatments for TB?

Answer 27

INH RIF, EMB PZA

Question 28

______can alter the metabolism of certain medications, making them less effective May also discolor contact lenses

Answer 28

Rifampin

Question 29

Hepatitis, neurologic changes (hearing loss, neuritis), rash

Answer 29

side effects of all drugs for TB

Question 30

you get headaches, flushing, hypotension, light headedness, palpitations and diaphoresis with tyramine if taking ____

Answer 30

INH

Question 31

First oral drug against TB Primary antitubercular drug May induce liver damage Used in combination with other drugs to treat active TB due to resistance Interferes with lipid RNA and DNA synthesis in the tubercle bacilli Bacteriostatic and acts specifically in tubercle bacilli Can be bactericidal in higher doses

Answer 31

isoniazid

Question 32

Side/Adverse Effects N/V, constipation (DIARRHEA) Liver damage HEPATITIS, LIVER FAILURE –MORE OFTEN SEEN IN OLDER ADULTS AND ALCOHOLICS ast alt, jaundice Peripheral neuropathy MORE COMMON WITH ALCOHOLICS AND DIABETICS can be given b 6, pyridoxine CNS symptoms dizziness, ataxia, seizures, psychotic symptoms

Answer 32

isoniazid

Question 33

Administration Tablet or oral syrup or combination Give oral drug on empty stomach (1 hour before meals) Give IM dose in large muscle mass and rotate sites If IM dose forms crystals, warm it to room temperature before administration Give in combination with other TB meds to reduce resistance in active TB Give Isoniazid alone for latent TB (6-9 month treatment) Stay on Treatment!!!

Answer 33

isoniazid

Question 34

Tell patients… To help with GI symptoms, take with food Report severe GI symptoms to provider Increase fiber and fluids to prevent constipation Report jaundice, abdominal pain and unusual fatigue Report numbness, tingling and pain in hands and feet Report CNS symptoms

Answer 34

isoniazid

Question 35

Contraindications Allergy to SeveHistory of liver damage from _____ re liver damage Precautions Chronic liver disease, hepatitis HIV infection Adults greater than 50 Seizure disorders Renal disorders Alcoholism

Answer 35

isoniazid

Question 36

Suppresses protein synthesis Bacteriostatic with some bactericidal activity against gram positive and gram negative bacteria Also effective against organisms responsible for leprosy and meningitis Available in IV or oral form

Answer 36

rifampin

Question 37

Can cause liver toxicity (hepatitis) Expect red-orange color of bodily fluids including urine, saliva, tears and sweat N/V, diarrhea, cramping and abdominal pain Can make oral contraceptives less effective

Answer 37

rifampin

Question 38

Contraindications Allergy to Obstructive gallbladder disease Current meningococcal disease Precautions History of liver disease History of alcoholism Concurrent use of other hepatotoxic drugs

Answer 38

rifampin

Question 39

Decreases blood levels of oral contraceptives, warfarin (Coumadin) and several HIV drugs (protease inhibitors)

Answer 39

rifampin

Question 40

Reduces length of treatment Reduces bacterial resistance Treatment divided into phases Susceptibility testing should occur prior to medication administration

Answer 40

multi drug therapy for tb

Question 41

Peripheral neuropathy most common reaction to isoniazid- monitor carefully- give pyridoxine to prevent Common reactions to rifampin- GI Ethambutol- itching, joint pain, GI, malaise, tingling of extremities Pyrazinamide-liver toxicity

Answer 41

adverse effects of anti tb drugs

Question 42

Sputum test for acid-fast bacilli will be negative 2 to 3 months after starting therapy Symptoms dissipate Client will not spread TB to others Often use directly observed therapy (DOT)

Answer 42

goal of treatment for tb patients

Question 43

when taking ____ bodily fluids may be red or orange

Answer 43

rifampin

Question 44

divided doses of ____ may cause visual disturbances

Answer 44

ethambutol

Question 45

collect sputum specimens for acid fast bacilli when?

Answer 45

first thing in the morning

Question 46

clients takin INH and ethambutol should have frequent _____

Answer 46

eye exams

Question 47

Close contact Immune compromise Conversion Children Family members Often lasts up to a year Contraindicated for those with liver disease

Answer 47

prophylactic treatment

Question 48

TB can be spread to other parts of the body via the bloodstream

Answer 48

miliary tb