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Tuberculosis (nursing management (advocating adherence to treatment…
Tuberculosis
nursing management
advocating adherence to treatment regimen: educate the medication, schedule, interaction & side effect
monitor the side effect of anti-tb medication
avoid alcohol & certain foods that interact with IHN (tuna, aged cheese)
educate pt about the risk of drug resistance if med regimen is not strictly and continuously followed
promote airway clearance: advice best position to facilitate airway clearance
promoting activity and adequate nutrition: progressive activity plan to increase activity tolerance and muscle strength
prevent spread of TB infection: maintain a good personal and environmental hygiene
seek treatment promptly if symptoms similar to tb appear
management
multiple drug therapy for >6months
4 drugs in the 1st 2 months: isoniazid (IHN), rifampicin, pyrazinamide, ethambutol
2 drugs in the subsequence 4 months: isoiazid, rifampicin
Regular drug treatment (DOT, directly observed treatment)
may modify the drug treatment to suit the particular needs of patients(e.g. patient develop drug resistance)
liver enzymes, blood urea nitrogen (BUN) & creatinine level & sputum examination
diagnostic and assessment finding
tuberculin skin test (mantoux test) - tubercle bacillus extract (puified protein derivative PPD) is injected intradermal layerof inner aspect of forearm
0-4mm of induration (hardening)
5mm/ greater (may be significant)
chest x-ray (lesion)
sputum examination
bronchoscopy
lung biopsy
Risk factor
elderly, immunocompromised patient, living in overcrowded housing, poor ventilation, smoking and alcohol use
S/S
loss of weight, evening fever, night sweat, loss of appetite and fatigue, coughing, dyspnea, chest pain, hemoptysis, clubbing of finger
an infectious disease affecting lung parenchyma; caused by mycobacterium tuberculosis (which is an AFB- Acid fast bacillus)
extrapulmonary TB: TB that transmitted to other parts of body, including kidney, meninges, bones
airborne transmitted (droplets through coughing/ sneezing)