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NUR 211 Test 2
- Pathophysiology of TB
Answer Infectious disease caused by Mycobacterium Tuberculosis which normally involves the lungs but any organ can be infected.
Once inhaled, the particles will lodge into the bronchioles and alveoli. It is aerophilic -Oxygen loving!Starts as a latent infection and can later turn into active TB.Symptoms Cough lasting more than 3 weeks, chest pain, hemoptysis, fatigue, night sweats, weight loss, chills, fever
- TB Procedures
Answer PPD Test
-Positive in all people regardless if >15 mm induration -Inject intradermally in forearm -Assess for induration in 48-72 hours Interferon gamma release assays blood test -Results in a few hours Chest X-ray -Abnormal Sputum is the gold standard for diagnosis of TB -3 consecutive sputum cultures 8-24 hour intervals, in the morning is best time
- TB Isoniazid
Answer Decreased B6 levels- anemia, glossitis, rashes, mental status changes Neurotoxicity- headache, confusion, limb weakness and numbness Nurse Considerations
Monitor for peripheral neuropathy, tired, irritable, depressed 1 / 3
- TB Rifampin
Answer Bodily fluids orange- sweat, tears, urine, Photosensitivity Liver problems- jaundice will appear in eyes first
Nurse Considerations
Educate on orange body fluids, Photosensitivity- sunscreen, stay indoors & away from windows, covering clothing, Assess for jaundice
- TB Streptomycin
Answer Watch out for tinnitus, ototoxicity, neurotoxicity, and nephrotoxicity
Still used for TB but is not the first line of therapy anymore Used to treat pts who cannot undergo the first line standard therapy due to drug-resistant Mycobacterium tuberculosis Given to patients that cannot take some of the first line meds due to being pregnant or breastfeeding, take in place of whichever drug they cannot take
- TB Patient Education
Answer Advise patient that they're no longer contagious after 2-3 weeks of starting therapy
Smoking cessation if patient smokes Cover nose and mouth with tissue when producing sputum, wear surgical mask when outside of negative pressure room, use proper hand hygiene After 2-3wks of treatment a sputum culture is needed every 2-4wks with a neg. result Restrict visitors, stay in separate rooms from other family members and home should be well-ventilated Be sure medication therapy is completed and taken as directed.Medication is taking for up to 12 months.Teach side effects of medications.
- TB Transmission/PPE/Protection
Answer Airborne Precautions- N-95, gloves, gown, put patient in negative pressure isolation room and cluster care 2 / 3
Hand hygiene and cover mouth and nose when cough/sneeze Tested for TB 6 months after exposure to a positive
- Which clinical manifestations is associated with a diagnosis of tuberculo- sis?
Answer Anorexia, Hemoptysis, Night Sweats
- Which clinical manifestations is associated with TB?
Answer Fatigue, Nausea, Low-grade Fever
- The nurse obtains a laboratory report that shows acid-fast rods in a clients sputum. Which
disorder would the nurse consider may be related to these results?
Answer Mycobacterium Tuberculosis
- A client is being admitted to a medical unit with a diagnosis of pulmonary tuberculosis.
Which type of room would the nurse assign this client?
Answer Negative airflow room
- A client is to undergo a tuberculin test as part of her prenatal workup. Before
administering the test, which information about the client would the nurse obtain?
Answer Whether the result of an earlier tuberculin test was positive
- After a client at an outpatient clinic has been diagnosed with active tu- berculosis, which
action by the nurse is best?
Answer Notify the local public health department of the new diagnosis
- Which action would the nurse take first after learning that sputum cultures for a client with a
chronic cough were positive for TB?
Answer Place the client on airborne precautions
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