Tb Flashcards
What are signs and symptoms of Tb
Fatigue
Weakness
Anorexia
Wt less
Night sweats
Low grade fever
Adenopathy
Malaise
Anxiety
Crackles
Diminished breath sounds
Hempotysis
Chest pain
productive cough
Tb is the leading cause of death in which immunocompromised pts
HIV/AIDES pts
How is TB spread
Airborne droplets
How long can TB be suspended in the air
For hours
What is required for transmission of TB
Close, frequent, or prolonged exposure
Who/what are at risk/have risk factors for TB
Homeless
Residents of inner-city neighborhoods
Foreign-born persons
Living or workin in healthcare institutions
IV drug users
Poverty, poor access to healthcare
Immunosuppression
Asian decent
What test do we do to determine if pt has TB
The Mantoux skin test
When doing the TB skin test, when should a pt come back after having the intradermal injection
48-72 hrs
If pt is immunocompromised how big does the Mantoux skin bump need to be for a positive TB result
greater than 5mm
What size should the skin test bump be for a pt who is at high risk for having TB
Greater than 10mm
If the pt is not high risk or immunocompromised, how big should the bump be for a positive TB skin test result
greater than 15mm
After a positive skin chest, what another diagnostic tool has to be done to confirm TB
A chest X-ray
What is the definitive way to diagnose TB
A sputum culture
When should we collect the sputum culture
In AM before eating or drinking
What should a pt rinse their mouth with doff doing sputum culture
Water
What if pt is on antibiotics when sputum is taken
Write what antibiotics pt is on and label accurately for lab
How long is pt infectious with a + sputum culture after starting treatment
2-3 weeks
How long does TB treatment typically take
6-9 mnths
What should we make sure the pt does not have a hx of
Hx of liver problems or disease
What beverage should Tb pts avoid
Alcohol
What s/s of liver complication should we teach a Tb pt
Loss of appetite
Fatigue
Malaise
Jaundice
Dark urine
Unusual abdominal symps
Should a pt stop taking Tb meds abruptly
No!
What masks should staff wear when pt is + for Tb
N-95
What type of air pressure should their be in the room of a + tb pt
Negative air pressure room
When a + Tb pt leaves the room to go somewhere, what does staff need to place on pt
A surgical mask
What are first line TB drugs
isoniazid
Rifampin
Ethmbutol
Pyranzinamide
What can isoniazid cause that is severe and sometimes fatal
Hepatitis
what should we watch to prevent sever and fatal hepatitis
Liver enzymes
What are all TB meds
Hepatotoxic
How many drugs will a TB pt take
Usually 2
Why will a tb pt take two tb drugs
To prevent them from getting a multi resistant organism
What should we monitor when a pt takes rifampin
Liver function
What should we tell pt to report when they’re taking rifampin
Abd pain
Fatigue
Yellowing of skin and eyes
Warn pt that body fluids may turn reddish orange which can stain soft lens contacts
Can interfere with birth control
What are adverse effects of rifampin
Hepatotoxicity
Anaphylaxis
Nephrotoxicity
Renal failure
Disseminated intravascular coagulation
Easy bleeding, slow clotting (report this to HCP)
When pyrazinamide is combined with rifampin what toxicity chance is increased
Liver toxicity
What disease should we ask a pt to watch for s/s of
Gout
What should people taking pyrazinamide be cautious about
Sensitivity
If a pt is taking ethmbutol, what changes in their body do they need to notify us about
Visual changes
Neuropathy
If you have the BCG vaccine what can happen when you have a skin TB test
It can result in a false positive
