Infectious Disease caused by what?
Mycobacterium Tuberculosis
Leading cause of death in what patients?
HIV/AIDS
Clinical Signs and Symptoms for TB Include? (14)
- Fatigue
- Weakness
- Anorexia
- Weightloss
- NIght Sweats
- Low Grade Fever
- Adenopathy
- Malaise
- Anxiety
- Crackles
- Diminished Breath Sounds
- Hemoptysis
- Chest Pain
- Productive Cough
How is this Disease spread? and how long can it be suspended in the air?
Spread Via Airborne Droplets .
Can be suspended in the air for minuets to hours.
What does transmission require and what is it not spread by?
Transmission requires close, frequent, or prolonged exposure.
Not spread by touching, sharing food utensils, kissing or other physical contact
What are the risk factors (something that predisposes) for TB? (8)
- Being Homeless
- Residents of Inner-city neighborhoods
- Foreign-Born Persons
- Living or Working in institutions (Includes healthcare workers)
- IV injecting Drug Users
- Poverty, Poor Access to Health Care
- Immunosupression
- Asian Descent
What is two-step testing for TB?
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.
How long can culture results take up to?
8 weeks
Lab and Diagnostic testing includes what four things?
- Tuberculin Skin Test
- Chest X-Ray
- Sputum Obtained (usually) on 2-3 consecutive days
- Interferon-Y Release Assay (IGRAS)
Interferon-Y Release Assay (IGRAS)
- 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
How long are pt’s infectious?
Infectious for the first 2-3weeks after starting treatment if sputum +.
when is isolation needed?
What patient teaching is necessary? (8)
- Treatment takes several months
- Pt. does not have hx of liver problems or disease
- Take meds w/ food if GI upset occurs
- Avoid Alcohol
- Teach s/s of liver complications
- Stress the importance of taking medication as prescribed, do not stop med unless consulted with physician
- Avoid certain foods: Fish (tuna), Aged Cheese (Tyramine)
- Administer 1hr prior to meals and 2 hours after for better absorption
Signs and Symptoms of Liver Complications? (6)
- Loss of Appetite
- Malaise
- Fatigue
- Jaundice
- Dark Urine
- Unusual Abdominal…
What are the Nursing Diagnosis for TB?
- Ineffective Airway Clearance
- Ineffective Breathing Pattern
- Fatigue
- Impaired Gas Exchange
- Ineffective Health Management
what isolation precaution is TB?
Airborne Precaution
- wear mask
- wash hands before leaving room
- N95 Mask
First Line Medications for TB:
- Isoniazid/ INH
- Rifampin
- Ethambutol
- Pyranzinamide
Isoniazid INH:
what is the dosing?
- 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
Isoniazid INH:
Adverse Effects include? 9
- Severe sometimes fatal hepatitis
- Increased Liver Enzymes
- Neuropathy
- Neurotoxicity
- Rash
- Hepatitis
- Injury of Liver
- Rhabdomyolsis
- Seizure
Patients can try to take what for neuropathy?
Pt. can try to take B6
Rifampin can be administered how? and the dosing?
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
what does the nurse need to monitor when their pt is taking rifampin?
Liver Function Tests (LFT’s)
what symptoms would you tell the pt to report, when taking Rifampin?
TELL PATIENT TO REPORT ABD PAIN, FATIGUE, OR YELLOWING OF SKIN OR EYES
what side effects would you warn pts about when talking Rifampin?
WARN PATIENTS THAT BODY FLUIDS MAY TURN REDDISH ORANGE WILL STAIN SOFT CONTACT LENS
