Tb

Question 1

What are signs and symptoms of Tb

Answer 1

Fatigue
Weakness
Anorexia
Wt less
Night sweats
Low grade fever
Adenopathy
Malaise
Anxiety
Crackles
Diminished breath sounds
Hempotysis
Chest pain
productive cough

Question 2

Tb is the leading cause of death in which immunocompromised pts

Answer 2

HIV/AIDES pts

Question 3

How is TB spread

Answer 3

Airborne droplets

Question 4

How long can TB be suspended in the air

Answer 4

For hours

Question 5

What is required for transmission of TB

Answer 5

Close, frequent, or prolonged exposure

Question 6

Who/what are at risk/have risk factors for TB

Answer 6

Homeless
Residents of inner-city neighborhoods
Foreign-born persons
Living or workin in healthcare institutions
IV drug users
Poverty, poor access to healthcare
Immunosuppression
Asian decent

Question 7

What test do we do to determine if pt has TB

Answer 7

The Mantoux skin test

Question 8

When doing the TB skin test, when should a pt come back after having the intradermal injection

Answer 8

48-72 hrs

Question 9

If pt is immunocompromised how big does the Mantoux skin bump need to be for a positive TB result

Answer 9

greater than 5mm

Question 10

What size should the skin test bump be for a pt who is at high risk for having TB

Answer 10

Greater than 10mm

Question 11

If the pt is not high risk or immunocompromised, how big should the bump be for a positive TB skin test result

Answer 11

greater than 15mm

Question 12

After a positive skin chest, what another diagnostic tool has to be done to confirm TB

Answer 12

A chest X-ray

Question 13

What is the definitive way to diagnose TB

Answer 13

A sputum culture

Question 14

When should we collect the sputum culture

Answer 14

In AM before eating or drinking

Question 15

What should a pt rinse their mouth with doff doing sputum culture

Answer 15

Water

Question 16

What if pt is on antibiotics when sputum is taken

Answer 16

Write what antibiotics pt is on and label accurately for lab

Question 17

How long is pt infectious with a + sputum culture after starting treatment

Answer 17

2-3 weeks

Question 18

How long does TB treatment typically take

Answer 18

6-9 mnths

Question 19

What should we make sure the pt does not have a hx of

Answer 19

Hx of liver problems or disease

Question 20

What beverage should Tb pts avoid

Answer 20

Alcohol

Question 21

What s/s of liver complication should we teach a Tb pt

Answer 21

Loss of appetite
Fatigue
Malaise
Jaundice
Dark urine
Unusual abdominal symps

Question 22

Should a pt stop taking Tb meds abruptly

Answer 22

No!

Question 23

What masks should staff wear when pt is + for Tb

Answer 23

N-95

Question 24

What type of air pressure should their be in the room of a + tb pt

Answer 24

Negative air pressure room

Question 25

When a + Tb pt leaves the room to go somewhere, what does staff need to place on pt

Answer 25

A surgical mask

Question 26

What are first line TB drugs

Answer 26

isoniazid Rifampin Ethmbutol Pyranzinamide

Question 27

What can isoniazid cause that is severe and sometimes fatal

Answer 27

Hepatitis

Question 28

what should we watch to prevent sever and fatal hepatitis

Answer 28

Liver enzymes

Question 29

What are all TB meds

Answer 29

Hepatotoxic

Question 30

How many drugs will a TB pt take

Answer 30

Usually 2

Question 31

Why will a tb pt take two tb drugs

Answer 31

To prevent them from getting a multi resistant organism

Question 32

What should we monitor when a pt takes rifampin

Answer 32

Liver function

Question 33

What should we tell pt to report when they’re taking rifampin

Answer 33

Abd pain Fatigue Yellowing of skin and eyes Warn pt that body fluids may turn reddish orange which can stain soft lens contacts Can interfere with birth control

Question 34

What are adverse effects of rifampin

Answer 34

Hepatotoxicity Anaphylaxis Nephrotoxicity Renal failure Disseminated intravascular coagulation Easy bleeding, slow clotting (report this to HCP)

Question 35

When pyrazinamide is combined with rifampin what toxicity chance is increased

Answer 35

Liver toxicity

Question 36

What disease should we ask a pt to watch for s/s of

Answer 36

Gout

Question 37

What should people taking pyrazinamide be cautious about

Answer 37

Sensitivity

Question 38

If a pt is taking ethmbutol, what changes in their body do they need to notify us about

Answer 38

Visual changes Neuropathy

Question 39

If you have the BCG vaccine what can happen when you have a skin TB test

Answer 39

It can result in a false positive