MS Chapter 33 part 3
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a highly communicable disease transmitted aerosolization and is caused by mycobacterium tuberculosis
The reactivation of the disease in a person that was already infected.
Why are many pt's not aware of the symptoms of tb until the disease has advanced?
Becaus TB has a slow onset.
why is the increase risk of acquiring tb greater in a peson who has HIV
Because they are immunocomprimised.
What is the most common used reliable test for TB.
the tuberculin Mantoux (PPD) test. it is purified protein given ID in the forarm.
an area of induration measuring __ or greater in diameter __ to __ hours after injection indicates exposure to an infection w/ TB
10mm, 48 to 72 hours. the area may be hardened and or reddened. remember that pt's with HIV the induration may only measure 5mm
Patients from other countries might have received a BCG vaccination againt TB. What problem would arise for this person receiving a PPD test?
Pt's who have had BCG usually have a large, positive reaction to a PPD skin test, making the test less reliable as an indicator of active TB disease
a pt with active tb who is hospitalized is placed where?
In a private room on Airborne precautions
What are some clinical manifestations of TB
- Progressive fatigue
- Weight loss
- Irregular Mensus
- Low-grade fever, night sweats
- cough, mucopurulent sputum, blood streaks
What type of people are at risk for TB
- HIV pt
- living in crowded conditions
- older people
- low socioeconomic groups
what are some physical manifestations of a person who has TB?
progressive fatigue, lethargy, nausea, anorexia, weight loss, irregular menses, and low grade fever.
This is obtained by a sputum and suggests a diagnoses of TB by a positive smear for what?
Acid fast bacillus
what confirms a diagnoses for TB
A sputum culture.
A pt who has TB will be on ariborn precautions. What does this mean for the health care workers involved?
They will have to wear masks or s respratory device when entering the room of negative air pressure.
What is the most effective method of treating active TB and preventing Transmission?
Combinatino drug therapy. Should be followed with strict adherence.
This type of drug used to treat TB should be taken on an empty stomach and needs to avoid antiacids. They should be taking a multi vitamin/ complex B vitamins and void drinking alcohol on this drug.
This type of drug used to treat TB stains the skin and urine and the pt needs to expect that all secretions will be have a reddish-orange tinge. Contacts lenses will be stained and women using oral contraceptives should use an extra method of contraception. No alcohol.
This type of drug used to reat TB requires that the patient to drink at least 8 oz of water when taking this tablet as well as increase fluid intake. Pt needs to where protective clothing when going out into the sunlight. No alcohol.
This type of drug used to treat TB requires tha pt report any changes in vision, such as reduced color vision, blurred vision, or reduced visual fields immediately. Also ask whether or not the pt has ever had gout. No alcohol
It is important to assess pt taking first-line drug therapy for TB for what?
any manifestation of liver impairment, such as dark urine, clay-colored stools, anorexia, jaundiced sclera or hard palat.
A negative sputum culture indicates that a pt is no longer being infectious with TB. How many does a pt need to have in order to be considered cured?
Need to have 3 negative sputum returns.
Somtimes direct observe therapy (DOT) is indicated for a pt with TB. what is this?
The nurse or other health care provider watches the pt swallow the drugs prescribed
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