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nursing 172 > Week 6: Tuberculosis > Flashcards

Week 6: Tuberculosis Flashcards

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1
Q

What Is It?

A

an infectious disease caused by Mycobacterium tuberculosis

  • primarily affects the lungs
  • life threatening
  • classified as latent, primary, primary progressive, and drug-resistant
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2
Q

How is TB Transmitted?

A

transmitted by aerosolization droplets inhaled from the coughing or sneezing of infected individuals

  • (airborne route)
  • droplets are tiny and can remain suspended in the air for several hours
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3
Q

What does TB affect?

A

-primarily affects the lungs but can spread to any organ in the blood

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4
Q

Diagnosis

A

diagnosis of TB infection is made by laboratory testing, a skin test, and a chest x-ray

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5
Q

Laboratory Testing

A

-Sputum test for culture and acid-fast staining

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6
Q

Chest-x ray

A

-suspicious cavitating lesions (resulting from pathologic processes leading to necrosis and formation of a “gas-filled” space within the lung tissue) are seen on chest x-rays

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7
Q

Skin Test

A

-positive purified protein derivative (PPD) screen skin test, also called Mantoux test

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8
Q

Blood Testing

A

-2 IRGAs
>QuantiFERON TB Gold In-Tube (QTF-GIT)
>T-SPOT TB test (T-SPOT)
-can determine if an individual has been infected with TB bacteria

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9
Q

Goals for Treatment

A

-cure the patient
-minimize the transmission of M. tuberculosis to other people
> a basic four-drug combination is recommended and should continue for 9-12 months

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10
Q

Four-drug Combination for TB

A
  • Isoniazid
  • Rifampin
  • Pyrazinamide
  • Ethambutol
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11
Q

Complications

A

extensive respiratory tissue destruction by M. tuberculosis can lead to:

  • respiratory failure
  • bronchopleural fistula formation (abnormal pathway or sinus tract that develops between the bronchus and pleural space)
  • TB can spread to parts of the body outside the respiratory system via the bloodstream and lymph circulation
  • extrapulmonary TB can present as meningitis, lymphadenopathy, bone disease, and liver and kidney failure
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12
Q

Clinical Manifestations

A
  • unexplained weight loss
  • night sweats
  • fever
  • chills
  • rusty-colored sputum
  • pleuritic chest pain from coughing
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13
Q

Nursing Assessments

A

Assess:

  • oxygen saturation
  • temperature
  • sputum
  • breath sounds (wheezing from irritated airways; rales and rhonchi from fluid/exudate)
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14
Q

Nursing Actions

A
  • humidified oxygen
  • institute airborne isolation
  • administer antibiotics as ordered
  • ensure adequate nutrition
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15
Q

Client Education

A
  • skin/blood testing for individuals living with or exposed to infected person
  • importance of completing all medication
  • assess support systems
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16
Q

Safety Alert

A
  • Immediate isolation of the patient with suspected or confirmed TB infection in a private room with negative airflow capabilities is a priority
  • airborne precautions
  • N95 mask respirator for healthcare personnel
  • snug-fitting surgical mask for visitors is essential
  • patients movement and transportation should be limited to essential needs only
  • patients who must leave the negative pressure room should also wear a surgical mask
17
Q

Risk Factors

A
  • frequent and close contact with an untreated individual
  • lower socioeconomic status and homelessness
  • immunocompromised status (HIV, chemotherapy, kidney disease, diabetes mellitus, Crohn’s disease)
  • poorly ventilated, crowded environments (correctional or long-term care facilities)
  • advanced age
  • recent travel outside the US to areas where TB is endemic
  • Immigration (especially from Mexico, Philippines, Vietnam, China, Japan, and Eastern Mediterranean countries)
  • substance use
  • health care occupation that involves performance of high-risk activities
18
Q

Nursing Diangoses

A
  • ineffective airway clearance
  • alteration in gas exchange r/t necrosis of lung tissue
  • ineffective coping r/t isolation and long-term therapy
19
Q

Why is there rusty colored sputum?

A

as a result of the destruction of the lung tissue during granuloma formation

nursing 172 (120 decks)

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