Tuberculosis Flashcards

0
Q

Tuberculosis

-Characterized by

A
  1. Pulmonary infiltrates
  2. Formation of Granulomas w/
    - Caseation
    - fibrosis
    - cavitation
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1
Q

Tuberculosis

-Caused by

A
  1. Mycobacterium tuberculosis (TB)

- bacterium that resembles a fungus

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2
Q

Tuberculosis

-Causes & Incidences

A
  1. 5% of infected people develop active TB w/in a year

2. Other 95% of people have Immune System that controls TB by enclosing it in a tiny nodule (Tubercle)

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3
Q

Tuberculosis

-Risk Factors

A
  1. Pt w/ Chronic disease (HIV)
  2. Employees of hospitals and long-term care facilities
  3. Injectable drug users
  4. Persons in close living conditions
  5. Persons born in countries with high prevalence of TB
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4
Q

Tuberculosis

-Transmission

A
  1. Droplet Nuclei
    - produced when infected person coughs, sneezes, talks, or sings
  2. Person with cavitary lesions are particularly infectious because their sputum usually contains 1 to 100 million bacilli per milliliter
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5
Q

Tuberculosis

-People w/ Cavitary Lesions

A
  1. Persons with cavitary lesions are particularly infectious because their sputum usually contains 1 to 100 million bacilli per milliliter
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6
Q

Tuberculosis

-Pathophysiology

A
  1. Inhaled Tubercle bacilli settle in alveolus
  2. Inflammatory response initiated
    - Alveolocapillary dilation and endothelial cell swelling occurs
  3. Microphages engulf bacilli and contain infection and stop disease.
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7
Q

Tuberculosis
-Pathophysiology
(The tubercle)

A
  1. May heal, leaving scar tissue
  2. May continue as a granuloma, then heal, or be reactivated
  3. May eventually proceed to necrosis, liquefaction, sloughing, and cavitation
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8
Q

Tuberculosis

-Complications

A
  1. Respiratory Failure
  2. Bronchopleural fistulas
  3. Pneumothorax
  4. Hemorrhage
  5. Pneumonia
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9
Q

Tuberculosis

-Signs & Symptoms

A
  1. 4-8 week incubation period
    - Asymptomatic
  2. May produce
    - fatigue, weakness, anorexia, weight loss, NIGHT SWEATS, and low grade fever
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10
Q

Tuberculosis

-S/S of Reactivation

A

May Include:

  1. A cough that produces muco-purulent sputum
  2. Occasional hemoptysis
  3. Chest Pains
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11
Q

Tuberculosis

-Diagnostic Test

A
  1. Chest X-ray
  2. Sputum smears & cultures
  3. Tuberculin skin test (PPD) purified protein derivative
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12
Q

Tuberculosis

-Treatment – 1st line agents

A
  1. Isoniazid
  2. Rifampin
  3. Ethambutol
  4. Pyrazinamide
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13
Q

Tuberculosis

-Treatment – Latent TB

A
  1. Daily Isoniazid for 9 months or w/ Rifampin for 4 months if resistant to Isoniazid
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14
Q

Tuberculosis

-Treatment – recommendation for most adults

A
  1. All 4 drugs daily for 2 months
    Followed by
  2. 4 months of Isoniazid (INH) and Rifampin (RIF)
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15
Q

Tuberculosis

-Nursing Considerations

A
  1. Initiate airborne and isolation precautions immediately for all pt’s suspected or confirmed to have TB
    - Private Room
    - Negative pressure room with a minimum of 6 exchanges per hour
    - HEPA mask (N95 masks) - need to be fit tested or use a PAPR
16
Q

Tuberculosis

-Nursing Considerations Cont…

A
  1. Be aware that INH may lead to hepatitis
    - If Pt complains of left upper quadrant pain notify the MD immediately
  2. Importance of drug compliance should be reinforced