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IM 3 > Tuberculosis > Flashcards

Tuberculosis Flashcards

1
Q

Infectious Disease caused by what?

A

Mycobacterium Tuberculosis

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2
Q

Leading cause of death in what patients?

A

HIV/AIDS

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3
Q

Clinical Signs and Symptoms for TB Include? (14)

A
  1. Fatigue
  2. Weakness
  3. Anorexia
  4. Weightloss
  5. NIght Sweats
  6. Low Grade Fever
  7. Adenopathy
  8. Malaise
  9. Anxiety
  10. Crackles
  11. Diminished Breath Sounds
  12. Hemoptysis
  13. Chest Pain
  14. Productive Cough
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4
Q

How is this Disease spread? and how long can it be suspended in the air?

A

Spread Via Airborne Droplets .
Can be suspended in the air for minuets to hours.

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5
Q

What does transmission require and what is it not spread by?

A

Transmission requires close, frequent, or prolonged exposure.
Not spread by touching, sharing food utensils, kissing or other physical contact

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6
Q

What are the risk factors (something that predisposes) for TB? (8)

A
  1. Being Homeless
  2. Residents of Inner-city neighborhoods
  3. Foreign-Born Persons
  4. Living or Working in institutions (Includes healthcare workers)
  5. IV injecting Drug Users
  6. Poverty, Poor Access to Health Care
  7. Immunosupression
  8. Asian Descent
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7
Q

What is two-step testing for TB?

A

It is recommended for healthcare workers getting repeated testing and those with decreased response to allergens
Two-step testing ensures future positive results accurately Interpreted.

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8
Q

How long can culture results take up to?

A

8 weeks

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9
Q

Lab and Diagnostic testing includes what four things?

A
  1. Tuberculin Skin Test
  2. Chest X-Ray
  3. Sputum Obtained (usually) on 2-3 consecutive days
  4. Interferon-Y Release Assay (IGRAS)
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10
Q

Interferon-Y Release Assay (IGRAS)

A
  • DETECTS T-CELL LYMPHOCYTES IN RESPONSE TO MYCOBACTERIA
  • INCLUDES QUANTIFERON-TB AND THE T-SPOT.TB TESTS
  • RAPID RESULTS
  • SEVERAL ADVANTAGES OVER TST BUT MORE EXPENSIVE
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11
Q

How long are pt’s infectious?

A

Infectious for the first 2-3weeks after starting treatment if sputum +.

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12
Q

when is isolation needed?

A
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13
Q

What patient teaching is necessary? (8)

A
  1. Treatment takes several months
  2. Pt. does not have hx of liver problems or disease
  3. Take meds w/ food if GI upset occurs
  4. Avoid Alcohol
  5. Teach s/s of liver complications
  6. Stress the importance of taking medication as prescribed, do not stop med unless consulted with physician
  7. Avoid certain foods: Fish (tuna), Aged Cheese (Tyramine)
  8. Administer 1hr prior to meals and 2 hours after for better absorption
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14
Q

Signs and Symptoms of Liver Complications? (6)

A
  1. Loss of Appetite
  2. Malaise
  3. Fatigue
  4. Jaundice
  5. Dark Urine
  6. Unusual Abdominal…
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15
Q

What are the Nursing Diagnosis for TB?

A
  1. Ineffective Airway Clearance
  2. Ineffective Breathing Pattern
  3. Fatigue
  4. Impaired Gas Exchange
  5. Ineffective Health Management
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16
Q

what isolation precaution is TB?

A

Airborne Precaution
- wear mask
- wash hands before leaving room
- N95 Mask

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17
Q

First Line Medications for TB:

A
  1. Isoniazid/ INH
  2. Rifampin
  3. Ethambutol
  4. Pyranzinamide
18
Q

Isoniazid INH:
what is the dosing?

A
  • Given in combination with another drug, to help prevention of resistant strains of TB
  • 5mg per Kg a day for 6-18 months - usually given PO but also comes in IV form
  • Avoid anything that will further cause liver damage
19
Q

Isoniazid INH:
Adverse Effects include? 9

A
  1. Severe sometimes fatal hepatitis
  2. Increased Liver Enzymes
  3. Neuropathy
  4. Neurotoxicity
  5. Rash
  6. Hepatitis
  7. Injury of Liver
  8. Rhabdomyolsis
  9. Seizure
20
Q

Patients can try to take what for neuropathy?

A

Pt. can try to take B6

21
Q

Rifampin can be administered how? and the dosing?

A

Can be given IV, PO, IM
10mg/kg Max 600 mg A day for 4-6 months
* not usually given for any other infections but mycobacterial infections

22
Q

what does the nurse need to monitor when their pt is taking rifampin?

A

Liver Function Tests (LFT’s)

23
Q

what symptoms would you tell the pt to report, when taking Rifampin?

A

TELL PATIENT TO REPORT ABD PAIN, FATIGUE, OR YELLOWING OF SKIN OR EYES

24
Q

what side effects would you warn pts about when talking Rifampin?

A

WARN PATIENTS THAT BODY FLUIDS MAY TURN REDDISH ORANGE WILL STAIN SOFT CONTACT LENS

25
Q

what other medication could interfere with Rifampin?

A

With Birth Control Pill/Implant

26
Q

what are the adverse effects of Rifampin? 8

A
  1. Hepatotoxicity: impairment of liver functions.
  2. Anaphylaxis: allergic reaction.
  3. Nephrotoxicity: rapid deterioration in the kidney function due to toxic affects of medicines and chemicals
  4. Renal Failure
  5. Disseminated intravascular coagulation: rare, causes abnormal blood clotting throughout the bodies blood-vessels
  6. easy bleeding, slow clotting
  7. may cause sun sensitivity
  8. report any bleeding to HCP.
27
Q

when pyrazinamide is combined with what medication, what can it cause?

A

when combined with rifampin it can increase chance liver toxicity

28
Q

What should the nurse warn a pt about when taking pyrazinamide?

A

INFORM PT. S/S OF GOUT (A FORM OF ARTHRITIS) AND TO BE CAUTIOUS ABOUT SENSITIVITY TO THE MEDICATION

29
Q

How is Pyrazinamide administered and what is the dosing?

A

Available PO IM and IV
15-30mg/k Q Day (once a day)

30
Q

What are the adverse effects of taking Pyrazinamide?

A
  1. Hyperuricemia: elevated uric acid level in the blood
    (normal: 6.8mg/dl and Above 7 is saturated, and can cause symptoms)
  2. Nausea
  3. vomiting
  4. Arthralgia: pain in joint
  5. Anemia
  6. Hepototoxicity: causes liver impairment/ function.
31
Q

what should we teach the patient to report when taking Ethambutol ?

A

Instruct the patient to report any visual changes, neuropathy to HCP
and its generally well tolerated

32
Q

How is Ethambutol administed and the dosing?

A

15mg/kg once a day

33
Q

What are the adverse effects of Ethambutol?

A
  1. Hepototoxicity
  2. Anaphylaxis
  3. Optic Nueritis: occurs when swelling or inflammation damages the optic nerve
34
Q

BCG vaccine stands for:

A

Bacillus of calmette and Guerin vaccine, live vaccine

35
Q

what are the adveres effects of bcg vaccine?

A
  1. nausea
  2. lymphadenopathy: swelling of the lymph nodes
  3. Increased frequency of urination
  4. Hepatitis: inflammation of the liver
  5. Anaphylaxis
36
Q

what can this vaccine, BCG, cause a false positive for?

A

Purified protein derivitive or PPD or TB skin test

37
Q

If you have HIV or been exposed to tb what is the diameter of the tb skin test?

A

> 5mm

38
Q

If you are a drug user or high risk patient what is the diameter of the TB skin test?

A

> 10mm

39
Q

Healthy individuals, diameter of the TB skin test?

A

> 15mm

40
Q

what is another name for the TB skin test?

A

PPD - purified protein derivative
Mantoux skin test
Tuberculin skin test

IM 3 (14 decks)

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