Week 2 - TB Flashcards
what is TB (tubercolosis)
- an infectious disease caused by mycobacterium tubercolosis
what does TB usually effect? what else might it effect (5)?
- the lungs
- may also effect the kidneys, brain, spine, joint, and liver
how is TB spread
- thru airborne drops
- coughing
- sneezing
- speaking
what are airborne precautions that must be used for a pt with TB (4)
- isolation until not infectious
- wear a high efficiency particulate (hepa) mask by all who enter the room
- must be in a negative pressure room
- room w regular air exchanges
what are risk factors for TB (6)
- low socioeconomic factors
- tight living quarters
- smokers
- pollution exposure
- alcohol and subtance abuse
- immunosuppresion (ex. HIV)
what are symptoms of TB (9)
- frequent, productive cough
- chest pain
- fever
- chills
- night sweats
- mucous
- malaise
- anorexia
- weight loss
dyspnea unsual
what are some complications of TB (5)
- miliary TB
- pleural effusion
- empyema
- TB pneumonia
- other organ involvement
what is miliary TB
- form of TB that results from lrg numbers of organisms invading the blood stream and spreading to all body organs
what other organs might become involved as a complication of TB (6)
- bone
- joint tissue
- kidneys
- adrenal glands
- lymph nodes
- genital tract
what diagnostics can be used to diagnose TB (3)
- tuberculin skin testing
- chest xray
- bacteriological studies (sputum)
what is the TB test (mantoux test)
- where purified protein derivative is injected w a TB needle on the inner part of the arm
- then read in 48-72 hrs
- the induration is measured in mm, size determines if the pt has been exposed or not
what is the treatment for active TB
- combo drug therapy
how long does treatment for TB last
6-9 months and they must be compliant
what are the first line drugs for TB (4)
- rifampin (RMP)
- ethambutol (EMB)
- pyrazinamide (PZA)
- isoniazid (INH)
- combo of these)
what is the purpose of combo therapy for treatment of TB
- increase effectiveness
- decrease development of resistance strains
what are second line drugs for TB? (2)
antibiotics
- levofloxacin
- streptomycin
when are second line drugs added to the regimen
- in drug resistant TB
why is follow-up care imp for pts on long-term therapy (3)
- monitor effectiveness
- monitor for side effects
- to ensure adherence
why is adherence so important in treatment of TB
leads to:
- treatment failures
- emergence of multidrug resistance
what is used to ensure adherence during tx of TB
Direct Observation Therapy (DOT
what is DOT
- involves observing the ingestion of every dose of medications for TB for the pt’s entire course of treatment
what is the major adverse effects of INH, RMP, and PZA? what indication does this have
hepatitis
- baseline liver function tests are done at start of treatment
- and is monitored throughout treatment (esp. if baseline is abnormal)
what is a latent TB infection
- this is when an individual is infected w m. tubercolosis but does not become acutely ill
= not contagious, not S&S
does a pt with latent TB require ttreatment?
- yes, otherwise it may become active
what is the typical treatment for latent TB
- lesser drug theraoy
- usually INH for 6-9 mo.
a pt with HIV and latent TB should take INH for how long?
- 9 mo.
what is important to prevent TB
- vaccination
what vaccine is used to prevent TB
bacille calmette-guerin (BCG) vaccine
how effective is the BCG vaccine
- efficacy is unclear
what would indicate that a pt with TB is no longer infectious
3 negative AFB (acid fast bacilli) smears
where are pts usually treated
- as outpatient
- in hospital care is rare, but if needed it will be for a shirt period
what can be used to reduce airborne TB organisms
- UV light
what should a pt with TB be taught (3)
- cover mouth with a paper tissue when sneezing or coughing
- tissue then goes into paper bag and is disposed, burned, or flushed
- careful handwashing techniques after handling sputum & tissues
