NU 246 (EXAM 3)-TUBERCULOSIS
Terms
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- PEOPLE AT RISK FOR TB
-
-ELDERLY
-FOREIGN BORN + CROWDED CONDITIONS
-HIV
-AFRICAN AMERICAN
-HOMELESS
-DRUG USERS -
TB INFECTION
-HOW IS IT DETECTED? -
BACILLUS HAS ESTABLISHED ITSELF IN THE BODY
-CAN BE DETECTED BY A POSITIVE SKIN TEST - TB DISEASE
-
BACILLUS CAN BE ISOLATED FROM SECRETIONS OR LUNG TISSUE
-CXR OR CLINICAL S/S - ETHAMBUTOL (MYAMBUTOL)
-
DOSE:15MG/KG IN A SINGLE DOSE EACH DAY
ACTION:BACTERIOSTATIC
S/E: OPTIC NEURITIS,GI DISTRESS,LIVER,INCREASED URIC ACID
NURSING:TAKE AS A SINGLE DOSE EACH DAY - PERIPHERAL NEURITIS
- NUMBNESS IN TOES
- IS TB HIGHLY CONTAGIOUS?
- NO, YOU MUST BE A HIGHLY SUSCEPTIBLE HOST IN ORDER TO GET TB
- TB (TUBERCULOSIS BACILLUS)
-
-AEROBIC
-ACID FAST
-AFB - PYRAZINAMIDE (PZA,ZINAMIDE)
-
DOSE:3 GRAMS/DAY DIVIDED INTO 3-4 DOSES
ACTION:BACTERIOCIDAL
S/E:HEPATOTOXICITY,INCREASED URIC ACID,CAREFUL USE W/ DIABETES
NURSING:INCREASE FLUIDS TO 2L/DAT - WHAT IS THE DRUG COURSE OF THERAPY FOR TB?
-
1ST 2 MONTHS: ISONIAID,RIFAMPIN,PYRAZINAMIDE,ETHAMBUTOL
FOR ANOTHER 4 MONTHS:ISONIAID,RIFAMPIN
**6 MONTHS TOTAL** - ISONIAZID (INH)
-
DOSE:300 MG/DAY
ACTION:BACTERIOCIDAL
S/E:PERIPHERAL NEURITIS,REVERSIBLE HEPATOXICITY (INCREASES W/ AGE)
NURSING:VIT B6(PYRIDOXINE)25-50MG/DAY FOR PERIPHERAL NEURITIS,MONITOR LIVER FCN - RIFAMPIN (RIFADIN)
-
DOSE:600 MG/DAY
ACTION:BACTERIOCIDAL
S/E:GI DISTRESS,LIVER,MENTAL CONFUSION,ORANGE/REDDISH BODY SECRETIONS,INACTIVATES BIRTH CONTROL PILLS
NURSING:TAKE AT HS (NIGHTTIME) - WHAT PT HISTORY SHOULD U GET FOR TB
-
-KNOWN EXPOSURE
-AT RISK=HIV +
REPORT VAGUE SYMPTOMS:
1.COUGH OF 3 WKS
2.NIGHT SWEATS
3.HORSENESS
4.WT LOSS, ANOREXIA - SKIN TEST
-
**MANTOUX TEST**
-PPD
-48 TO 72 HRS READ - WHAT DOES NURSE LOOK FOR IN A TB TEST
-
-HARDNESS
-INDURATION OF 10MM OR MORE
-A SIGNIFICANT RXN
CLOSE CONTACT 5-9 MM IS SIGNIFICANT - REACTION IS SUPPRESSED W/
- RECENT VIRAL INFECTION
- IF A PT IS HIV+ OR ON CORTICOSTERIODS,PT WILL BE_
- INJECTED WITH MUMPS AND RXN TESTED
- SPUTUM TEST
-
-AFB
-ONLY CONFIRMATIVE TEST
-3 (AM) SPECIMENS
-SMEAR 24 HR
-CULTURE 2-12 WKS (10-14 DAYS RAPID) - WHAT DOES NURSE LOOK FOR IN CXR- CHEST X RAY?
- NURSE LOOKS FOR BLACK DOTS
- SYMPTOMATIC TXT
- EVERY DAY NUTRITION HEALTH TEACHING
- BCG VACCINE
-
-BACILLI CALMETTI GUERIN
-EFFECTIVENESS IS BETWEEN 0-80 PERCENT
-USED TO PREVENT TB
-FOUND UNRELIABLE
-SEEN IN EUROPEAN COUNTRIES - COMPLICATIONS OF TB
-
**DRUG RESISTANT TB**
-IN PRISON POPULATION/HIV +
DUE TO NONCOMPLIANCE - DOT THERAPY
-
DIRECTLY OBSERVED THERAPY
-TB PERSON IS FOLLOWED BY HEALTH DEPT - TB NURSING DIAGNOSIS
-
-KNOWLEGE DEFICIT
-IMPAIRED GAS EXCHANGE
-ALTERATION IN NUTRITION
-SOCIAL ISOLATION
-NON COMPLIANCE - TXT OF TB
-
-RELIEF OF SYMPTOMS
-ADHERENCE TO TXT REGIMEN - DRUG THERAPY
-
-RAPID REDUCTION IN # OF TB CELLS
-TXT LONG ENOUGH TO ELIMINATE PERSISTANT ORGANISMS
-COMBINATION OF 3-4 DRUGS: FOR 6 MONTHS - PREVENTATIVE THERAPY FOR TB
- INH 6-12 MOS FOR RECENT PPD CONVERTER
- INFECTION CONTROL FOR TB
-
-AIRBORNE PRECAUTIONS
-RESPIRATOR(NEEDS TO FIT)
-D'C PRECAUTIONS AFTER 2-3 WKS OF TXT
-UV LIGHT
-NEGATIVE PRESSURE (6 AIR EXCHANGE/HR)
-SPUTUM C+S EVERY 2-4 WKS
-WATCH(FOMITE)
-PT WEARS RESPIRATOR IF BEING DC