Question

A patient who had been living in South East Asia for the past two years has just been diagnosed with tuberculosis. He is complaining of night sweats, fatigue, and weight loss. He has a productive cough. 1. The CDC recommends screening people at high risk for TB. List at least five populations at high risk for developing active disease. 2. What is the route of transmission for tuberculosis and what what isolation precautions are required while the patient is hospitalized? 3. Therapy for TB consists of several medications. What medications would you expect to be prescribed for this patient? 4. At what point will this patient no longer be considered contagious? 5. What teaching points are especially important for this patient? 6. Non-adherence to drug therapy is a major problem that leads to treatment failure, drug resistance, and continued spread of TB. The CDC recommends methods to ensure compliance with medication for all patients who have drug-resistant TB and for those who take medication two or three times every week. Identify one of those methods. 7. List at least four nursing diagnoses that apply to this patient and his family.

Answer 1

Answer :

1 ) answer :

• Persons with human immuno deficiency virus ( HIV ) infection.
• Persons who were infected with M. Tuberculosis with in the past 2 years .
• Infant and young children .
• Close contact of person exposed to contageous cases of TB .
• Person with past history of inadequately treated TB .
• Health care workers who are serve for TB patients .
• Malnourished people .
• Low immunity people
• Who are living in a high crowded and positive TB areas .

2) TB is transmitted from one person to another through the air ,when a person with TB of the lungs ,coughs ,sneezes ,the droplets containing bacteria are released in to air .

• M.tuberculosis is carried in airborne particles ,called droplets nuclei of 1 -5 microns in diameter .

Precautions :

• Clean hands frequently ,especially after coughing and sneezing .
• Keep the room door closed at all times
• Be sure visitors read the sign on patient door.
• Leave the room only when medically necessory and wear a mask when you do.
• Limit the visitor to a few family members and friends who have immunity to patient illness .

3) therapy :

• Isoniazid .
• Rifampicin.
• Pyrazinamide.
• Ethambutol.
• Streptomycin .

Empiric treatment of TB start patient on a 4 drug regimen includes isoniazid ,rifampicin ,pyrazinamide ,either ethambutol or streptomycin .

- if isolated resistance of isoniazid is documented discontinue the drug and continue rifampicin ,pyrazinamide ,ethambutol for entire 6 months .

4) if he diagnosed with TB ,then immediately start the TB drugs ,so there is no contageous with patient .

5) health education about health diet .

Instruct the patient to wear mask.

Instruct the patient to hold hand key when he sneezes and coughs .

Adviced have hand wash after coughing and sneezing .

Adviced to Use the medication regularly with out fail

6) Dots therapy will be help ful and multi drug resistant therapy .

7)

• Imbalanced nutrition less than body requirement
• Ineffective airway clearance related to presence if sputum in bronchi.
• Acute pain related to inflammatory process in lungs .
• Impaired sleeping pattern related to cough .
• Knowledge deficit related to treatment regimen .
• Ineffective coping with family members .