TUBERCULOSIS

DEFINATION OF TUBERCULOSIS

A potentially serious infectious bacterial disease that mainly affects the lungs. The bacteria that cause TB are spread when an infected person coughs or sneezes.

TYPES

1. Active TB Disease: Active TB is an illness in which the TB bacteria are rapidly multiplying and invading different organs of the body.

2. Miliary TB:  Miliary TB is a rare form of active disease that occurs when TB bacteria find their way into the bloodstream.

3. Latent TB Infection: Latent tuberculosis infection (LTBI) is a state of persistent immune response to stimulation by Mycobacterium tuberculosis antigens without evidence of clinically manifested active TB. Someone has latent TB if they are infected with the TB bacteria but do not have signs of active TB disease and do not feel ill.

CAUSES OF T.B

Tuberculosis (TB) is caused by a type of bacterium called Mycobacterium tuberculosis (I.e the causative organism)

MODE OF TRANSMISSION

It's spread when a person with active TB disease in their lungs coughs or sneezes and someone else inhales the expelled droplets, which contain TB bacteria.

INCUBATION PERIOD OF TUBERCULOSIS

The incubation period may vary from about two to 12 weeks. A person may remain contagious for a long time (as long as viable TB bacteria are present in sputum) and can remain contagious until they have been on appropriate therapy for several weeks.

PATHOPHYSIOLOGY OF TUBERCULOSIS

Tuberculosis is a potentially serious infectious bacterial disease that mainly affects the lungs is caused by a type of bacterium called Mycobacterium tuberculosis. It's spread when a person with active TB disease in their lungs coughs or sneezes and someone else inhales the expelled droplets, which contain TB bacteria. 

The tubercle bacilli establish infection in the lungs after they are carried in droplets small enough (5 to 10 microns) to reach the alveolar spaces. If the defense system of the host fails to eliminate the infection, the bacilli proliferate inside alveolar macrophages and eventually kill the cells.

SIGNS AND SYMPTOMS OF T. B

💉Breathing difficulty.

💉Chest pain.

💉Cough (usually with mucus)

💉Coughing up blood.

💉Excessive sweating, particularly at night.

💉Fatigue.

💉Fever.

💉Weight loss.

COMPLICATIONS OF T. B

Pulmonary complications of TB can include:

 💉hemoptysis,

 💉pneumothorax, 

💉bronchiectasis, 

💉extensive pulmonary destruction,

 💉malignancy, 

💉and chronic pulmonary aspergillosis.

COMPLICATIONS OF T. B

Pulmonary complications of TB can include:

 💉hemoptysis,

 💉pneumothorax, 

💉bronchiectasis, 

💉extensive pulmonary destruction,

 💉malignancy, 

💉and chronic pulmonary aspergillosis.

MEDICAL MANAGEMENT FOR T. B

Most patients with active tuberculosis should be treated initially with 

*isoniazid,*

*rifampin* 

*pyrazinamide,* 

and *ethambutol* 

for eight weeks, followed by 18 weeks of treatment with: *isoniazid*

 and *rifampin*. 

Repeat cultures should be performed after the initial eight-week treatment.

We will be looking at how we can manage such patient using  nursing process:

ACRONYM: A. D. P. I. E

Someone should kindly help me out with the full meaning of the above acronym..

NURSING MANAGEMENT USING NURSING PROCESS FOR PATIENTS WITH T. B

Nursing management includes the following:

Nursing Assessment

The nurse may assess the following:

*Complete history: Past and present medical history is assessed as well as both of the parents’ histories.

*Physical examination : A TB patient loses weight dramatically and may show the loss in physical appearance.

Observation

Physical examination for extra pulmonary tuberculosis and vital sign check..

In diagnosis our patients we take into consideration PES

p-problem 

E-etiology

S-signs and symptoms

Nursing Diagnosis

Based on the assessment data, the major nursing diagnoses for the patient include:

-Risk for infection related to inadequate primary defenses and lowered resistance.

-Ineffective airway clearance related to thick, viscous, or bloody secretions.

-Risk for impaired gas exchange related to decrease in effective lung surface.

-Activity intolerance related to imbalance between oxygen supply and demand.

-Imbalanced nutrition: less than body requirements related to inability to ingest adequate nutrients.

Nursing Care Planning & Goals

The major goals for the patient include:

-Promote airway clearance.

Adhere to treatment regimen.

-Promote activity and adequate nutrition.

-Prevent spread of tuberculosis infection.

Evaluation

Expected patient outcomes include:

💉Promoted airway clearance.. Airways was cleared. 

💉Adhered to treatment regimen.

Patients adhere to her drugs routinely. 

💉Promoted activity and adequate nutrition. Patient was able to carry out her activities of daily living and takes adequate nutrition. 

💉Prevented spread of tuberculosis infection..

Patient did not infect others in the ward nor her health care-givers..