TB tuberculosis Flashcards
What is TB
infectious disease with micro bacterium tuberculosis
How is TB transmitted?
Airborne
How do they diagnosis TB?
TB is encased, forms a round nodule or tubercle and it shows up on an X-ray
Does TB only infect the lungs?
Typically, but it can spread to any organ in the blood
When does the risk of transmission decrease?
2-3 weeks after antituburculin therapy
How do you prevent TB
if you live in high risk areas you should be screened every year
Family members should be screened
migrant farm workers and people outside US are high risk
How does TB come up
Slow onset, may not be aware until advancement of disease
TB diagnosis possibilities
Persistent cough
chest pain
weakness
weight loss
anorexia
hemoptysis dyspnea
fever
night sweats
chills
How can you get TB?
contact w/untreated
socioeconomic status
immunocompromised
crowded environments
age
travel outside US
immigration
substance use
health care occupation
What should you expect from infected people?
Persistant cough longer than 3 weeks
purulent sputum, possibly blood streaked
fatigue lethargy
weight loss anorexia
night sweats low grade fever
How do you test for TB?
Nucleic amp. test
rapid tests are mostly accurate
When are results for test available for Nucleic Acid?
2 hrs
Quantiferon-TB Gold
Blood test: whole blood sample
active/latent testing
available within 24 hr.
What does the nurse (you) do to test?
Obtain 3 samples in the early morning
wear protective equipment
obtain samples in negative airflow room
Montoux test
within 2-10 weeks of exposure
intradermal infection-read 48-72 hrs
Why do they do a chest x-ray?
detect active lesions in lungs
What now?
Admin heated and humidified oxygen
prevent transmission
medications
nutrition
emotional support
What is the PPE you’ll use?
N-95 mask
negative air flow
barrier protection
client wears mask
teach client to cough into tissue
what steps do you take for nutrition?
fluid intake
well balanced diet
foods rich in: protein, iron, vitamin C, and B
what medications are prescribed for TB?
Combo therapy taken 6-12 months
isoniazid, rifampin, pyrazinamide, ethambutol
what medications are prescribed for TB?
Combo therapy taken 6-12 months
isoniazid, rifampin, pyrazinamide, ethambutol
Why does the client need to complete series of Rx prescribed?
all bacteria needs to be gone, decreases the chance of resistance
What does Isoniazid do? (INH)
inhibits growth of micro bacteria kills wall of mycelia acid
How do you take Isoniazid?
empty stomach
monitor: hepatotoxicity
Vitamin B6
LFT (prior) and monthly after
Education Isoniazid
No alcohol
=hepatotoxicity
reports signs of hepatotoxicity
What are signs of hepatotoxicity
Jaundice
anorexia
malaise
fatigue
nausea
nephrotoxicity (tingling hands and feet)
Rifampin RIF what does this do?
Bacteriacidal antibiotic-inhibits DNA RNA
What do you watch out for with Rifampin?
Hepatotoxicity
Liver function testing (prior-and monthly after)
Rifampin education
your urine and secretions will be orange
report signs of pain, swelling, joints, loss of appetite, jaundice, malaise
can interfere with oral contraceptives.
Pyrazinamide PZA what it do?
bacteriostatic and cidal
What do you monitor for with PZA
hepatotoxicity
gout history
LFT*****baseline and every 2!! weeks
Education PZA
Glass o’water
prevents gout and kidney problems
report yellowing skin/eyes, pain, swelling of joints, or malaise immediately
no alcohol
Ethambutol EMB
suppresses RNA (no kids 8<)
What are you going to assess for?
baseline visual acuity
monthly
color discriminations ability before
stop if ya hit toxic
What are you gonna report right away with EMB
visual changes
Streptomycin sulfate
amino glycoside antibiotic. potentiation of macrophages
Nursing actions
ONLY used with pt.’s with multi drug resistance
OTOTOXIC
report change in urine and renal
Client Education
Drink at least 2L of fluid
Notify of hearing problem
Who helps with assistance for TB meds?
Social services
Where can you refer them to follow up?
community clinic -monitors medication regimen and status of disease
Education Client
treated at home
Airborne precautions not needed at home
exposed family=get tested
take medication completely 6-12 months up to 2 years for drug resistant TB
Follow up care for full year
proper hand hygiene
cover mouth sneezing coughing
tissues used go into plastic bag
Active TB wear masks
How often are TB sputum samples needed
every 2-4 weeks
when are you considered no longer infectious?
after three consecutive sputum samples
