Tuberculosis Flashcards
0
Q
Tuberculosis
-Characterized by
A
- Pulmonary infiltrates
- Formation of Granulomas w/
- Caseation
- fibrosis
- cavitation
1
Q
Tuberculosis
-Caused by
A
- Mycobacterium tuberculosis (TB)
- bacterium that resembles a fungus
2
Q
Tuberculosis
-Causes & Incidences
A
- 5% of infected people develop active TB w/in a year
2. Other 95% of people have Immune System that controls TB by enclosing it in a tiny nodule (Tubercle)
3
Q
Tuberculosis
-Risk Factors
A
- Pt w/ Chronic disease (HIV)
- Employees of hospitals and long-term care facilities
- Injectable drug users
- Persons in close living conditions
- Persons born in countries with high prevalence of TB
4
Q
Tuberculosis
-Transmission
A
- Droplet Nuclei
- produced when infected person coughs, sneezes, talks, or sings - Person with cavitary lesions are particularly infectious because their sputum usually contains 1 to 100 million bacilli per milliliter
5
Q
Tuberculosis
-People w/ Cavitary Lesions
A
- Persons with cavitary lesions are particularly infectious because their sputum usually contains 1 to 100 million bacilli per milliliter
6
Q
Tuberculosis
-Pathophysiology
A
- Inhaled Tubercle bacilli settle in alveolus
- Inflammatory response initiated
- Alveolocapillary dilation and endothelial cell swelling occurs - Microphages engulf bacilli and contain infection and stop disease.
7
Q
Tuberculosis
-Pathophysiology
(The tubercle)
A
- May heal, leaving scar tissue
- May continue as a granuloma, then heal, or be reactivated
- May eventually proceed to necrosis, liquefaction, sloughing, and cavitation
8
Q
Tuberculosis
-Complications
A
- Respiratory Failure
- Bronchopleural fistulas
- Pneumothorax
- Hemorrhage
- Pneumonia
9
Q
Tuberculosis
-Signs & Symptoms
A
- 4-8 week incubation period
- Asymptomatic - May produce
- fatigue, weakness, anorexia, weight loss, NIGHT SWEATS, and low grade fever
10
Q
Tuberculosis
-S/S of Reactivation
A
May Include:
- A cough that produces muco-purulent sputum
- Occasional hemoptysis
- Chest Pains
11
Q
Tuberculosis
-Diagnostic Test
A
- Chest X-ray
- Sputum smears & cultures
- Tuberculin skin test (PPD) purified protein derivative
12
Q
Tuberculosis
-Treatment – 1st line agents
A
- Isoniazid
- Rifampin
- Ethambutol
- Pyrazinamide
13
Q
Tuberculosis
-Treatment – Latent TB
A
- Daily Isoniazid for 9 months or w/ Rifampin for 4 months if resistant to Isoniazid
14
Q
Tuberculosis
-Treatment – recommendation for most adults
A
- All 4 drugs daily for 2 months
Followed by - 4 months of Isoniazid (INH) and Rifampin (RIF)
15
Q
Tuberculosis
-Nursing Considerations
A
- Initiate airborne and isolation precautions immediately for all pt’s suspected or confirmed to have TB
- Private Room
- Negative pressure room with a minimum of 6 exchanges per hour
- HEPA mask (N95 masks) - need to be fit tested or use a PAPR
16
Q
Tuberculosis
-Nursing Considerations Cont…
A
- Be aware that INH may lead to hepatitis
- If Pt complains of left upper quadrant pain notify the MD immediately - Importance of drug compliance should be reinforced
