TB tuberculosis

Question 1

What is TB

Answer 1

infectious disease with micro bacterium tuberculosis

Question 2

How is TB transmitted?

Answer 2

Airborne

Question 3

How do they diagnosis TB?

Answer 3

TB is encased, forms a round nodule or tubercle and it shows up on an X-ray

Question 4

Does TB only infect the lungs?

Answer 4

Typically, but it can spread to any organ in the blood

Question 5

When does the risk of transmission decrease?

Answer 5

2-3 weeks after antituburculin therapy

Question 6

How do you prevent TB

Answer 6

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

Question 7

How does TB come up

Answer 7

Slow onset, may not be aware until advancement of disease

Question 8

TB diagnosis possibilities

Answer 8

Persistent cough
chest pain
weakness
weight loss
anorexia
hemoptysis dyspnea
fever
night sweats
chills

Question 9

How can you get TB?

Answer 9

contact w/untreated
socioeconomic status
immunocompromised
crowded environments
age
travel outside US
immigration
substance use
health care occupation

Question 10

What should you expect from infected people?

Answer 10

Persistant cough longer than 3 weeks
purulent sputum, possibly blood streaked
fatigue lethargy
weight loss anorexia
night sweats low grade fever

Question 11

How do you test for TB?

Answer 11

Nucleic amp. test
rapid tests are mostly accurate

Question 12

When are results for test available for Nucleic Acid?

Answer 12

2 hrs

Question 13

Quantiferon-TB Gold

Answer 13

Blood test: whole blood sample
active/latent testing
available within 24 hr.

Question 14

What does the nurse (you) do to test?

Answer 14

Obtain 3 samples in the early morning
wear protective equipment
obtain samples in negative airflow room

Question 15

Montoux test

Answer 15

within 2-10 weeks of exposure
intradermal infection-read 48-72 hrs

Question 16

Why do they do a chest x-ray?

Answer 16

detect active lesions in lungs

Question 17

What now?

Answer 17

Admin heated and humidified oxygen
prevent transmission
medications
nutrition
emotional support

Question 18

What is the PPE you’ll use?

Answer 18

N-95 mask
negative air flow
barrier protection
client wears mask
teach client to cough into tissue

Question 19

what steps do you take for nutrition?

Answer 19

fluid intake
well balanced diet
foods rich in: protein, iron, vitamin C, and B

Question 20

what medications are prescribed for TB?

Answer 20

Combo therapy taken 6-12 months
isoniazid, rifampin, pyrazinamide, ethambutol

Question 21

what medications are prescribed for TB?

Answer 21

Combo therapy taken 6-12 months
isoniazid, rifampin, pyrazinamide, ethambutol

Question 22

Why does the client need to complete series of Rx prescribed?

Answer 22

all bacteria needs to be gone, decreases the chance of resistance

Question 23

What does Isoniazid do? (INH)

Answer 23

inhibits growth of micro bacteria kills wall of mycelia acid

Question 24

How do you take Isoniazid?

Answer 24

empty stomach
monitor: hepatotoxicity
Vitamin B6
LFT (prior) and monthly after

Question 25

Education Isoniazid

Answer 25

No alcohol
=hepatotoxicity
reports signs of hepatotoxicity

Question 26

What are signs of hepatotoxicity

Answer 26

Jaundice
anorexia
malaise
fatigue
nausea
nephrotoxicity (tingling hands and feet)

Question 27

Rifampin RIF what does this do?

Answer 27

Bacteriacidal antibiotic-inhibits DNA RNA

Question 28

What do you watch out for with Rifampin?

Answer 28

Hepatotoxicity
Liver function testing (prior-and monthly after)

Question 29

Rifampin education

Answer 29

your urine and secretions will be orange
report signs of pain, swelling, joints, loss of appetite, jaundice, malaise
can interfere with oral contraceptives.

Question 30

Pyrazinamide PZA what it do?

Answer 30

bacteriostatic and cidal

Question 31

What do you monitor for with PZA

Answer 31

hepatotoxicity
gout history
LFT*****baseline and every 2!! weeks

Question 32

Education PZA

Answer 32

Glass o’water
prevents gout and kidney problems
report yellowing skin/eyes, pain, swelling of joints, or malaise immediately
no alcohol

Question 33

Ethambutol EMB

Answer 33

suppresses RNA (no kids 8<)

Question 34

What are you going to assess for?

Answer 34

baseline visual acuity
monthly
color discriminations ability before
stop if ya hit toxic

Question 35

What are you gonna report right away with EMB

Answer 35

visual changes

Question 36

Streptomycin sulfate

Answer 36

amino glycoside antibiotic. potentiation of macrophages

Question 37

Nursing actions

Answer 37

ONLY used with pt.’s with multi drug resistance
OTOTOXIC
report change in urine and renal

Question 38

Client Education

Answer 38

Drink at least 2L of fluid
Notify of hearing problem

Question 39

Who helps with assistance for TB meds?

Answer 39

Social services

Question 40

Where can you refer them to follow up?

Answer 40

community clinic -monitors medication regimen and status of disease

Question 41

Education Client

Answer 41

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

Question 42

How often are TB sputum samples needed

Answer 42

every 2-4 weeks

Question 43

when are you considered no longer infectious?

Answer 43

after three consecutive sputum samples