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CLINICAL SPECIALITY  II CARDIOVASCULAR & THORACIC
NURSING
UNIT V CARDIAC DISORDERS AND NURSING MANAGEMENT
TUBERCULOSIS
General objective:
 At the end of this class students will be acquainted with
Tuberculosis.
Specific objective:
 Define Tuberculosis.
 Mention the causes of Tuberculosis
 Discuss the types of Tuberculosis
 Describe clinical manifestation of Tuberculosis
 Discuss management of Tuberculosis.
1 tuberculosis
 Tuberculosis is an infectious disease caused by
mycobacterium tuberculosis. It usually involves the
lungs, but it also occurs in the larynx, kidneys , bones,
adrenal glands, lymph nodes and meninges and can be
disseminated throughout the body.
TUBERCULOSIS
MODE OF TRANSMISSION
 Close contact with TB patient.
 Inhalation of airborne nuclei from an infected person.
 Immunocompromised status ( HIV, Cancer, prolonged
high-dose corticosteroid therapy)
 Substance abuse.
 Pre-existing medical condition.
 Living in overcrowded , substandard living.
RISK FACTORS
1 tuberculosis
Exposure to source
Aerosolization of droplet
nuclei
Inhalation of bacteria
Bacteria reach lungs enter
macrophages
Bacteria multiply in
macrophages
Granulomatous lesions begins
to form ( caseous necrosis)
Lesion liqifies & spread to
blood , organs
Death
1 tuberculosis
 Tuberculin skin test
 Chest x- ray
 Bacterial studies
 Quantiferon-TB(QFT)
Diagnostic evaluation
1 tuberculosis
First line drugs PERIS
 Pyrazinamide.
 Ethambutol.
 Rifampicin.
 Isoniazid.
 Streptomycin.
Second Line drugs:
 Fluroquinolones.
 Aminoglycosides (Kanamycin, amikacin, capreomycin)
 Ethionamide
 P-Amino salicylic acid
 Cylcoserine.
1 tuberculosis
Improving Breathing Pattern
 Administer and teach self-administration of medications
as ordered
 Encourage rest and avoidance of exertion
 Monitor breath sounds, respiratory rate, sputum
production, and dyspnea
 Provide supplemental oxygen as ordered.
NURSING MANAGEMENT
Preventing Transmission of Infection
 Be aware that TB is transmitted by respiratory droplets or
secretions.
 Provide care for hospitalized patient in a negative-pressure
room to prevent respiratory droplets from escaped when
door is opened.
 Enforce rule that all staff and visitors use well-fitted
standard dust/mist/fume masks for contact with patient.
 Use high-efficiency particulate masks, such as high-
efficiency particulate air (HEPA) filter masks, for high-
r_M procedures, including suctioning, bronchoscopy, or
pentamidine treatments.
 Use standard precautions for additional protection
gowns and gloves for direct contact with patient, linens ::
articles in room, meticulous hand washing.
Improving Nutritional Status
 Explain the importance of eating a nutritious diet to
promote healing and improve defense against infection.
 Provide small, frequent meals and liquid supplements
during symptomatic period.
 Monitor weight.
 Administer vitamin supplements, as ordered, particularly
pyridoxine (vitamin B(.) to prevent peripheral neuropathy
in patients taking isoniazid.
Improving Compliance
 Educate the patient about the etiology, transmission, and
effects of TB. Stress the importance of continuing to take
medicine for the prescribed time because bacilli multiply
slowly and thus can only be eradicated over a long period
 Review adverse effects of the drug therapy. Question the
patient specifically about common toxicities of drugs
being used, and emphasize immediate reporting should
these occur.
 Participate in observation of medication taking, weekly pill
counts, or other programs designed to increase compliance with
treatment for TB.

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1 tuberculosis

  • 1. CLINICAL SPECIALITY II CARDIOVASCULAR & THORACIC NURSING UNIT V CARDIAC DISORDERS AND NURSING MANAGEMENT TUBERCULOSIS
  • 2. General objective: At the end of this class students will be acquainted with Tuberculosis. Specific objective: Define Tuberculosis. Mention the causes of Tuberculosis Discuss the types of Tuberculosis Describe clinical manifestation of Tuberculosis Discuss management of Tuberculosis.
  • 4. Tuberculosis is an infectious disease caused by mycobacterium tuberculosis. It usually involves the lungs, but it also occurs in the larynx, kidneys , bones, adrenal glands, lymph nodes and meninges and can be disseminated throughout the body. TUBERCULOSIS
  • 6. Close contact with TB patient. Inhalation of airborne nuclei from an infected person. Immunocompromised status ( HIV, Cancer, prolonged high-dose corticosteroid therapy) Substance abuse. Pre-existing medical condition. Living in overcrowded , substandard living. RISK FACTORS
  • 8. Exposure to source Aerosolization of droplet nuclei Inhalation of bacteria Bacteria reach lungs enter macrophages Bacteria multiply in macrophages Granulomatous lesions begins to form ( caseous necrosis) Lesion liqifies & spread to blood , organs Death
  • 10. Tuberculin skin test Chest x- ray Bacterial studies Quantiferon-TB(QFT) Diagnostic evaluation
  • 12. First line drugs PERIS Pyrazinamide. Ethambutol. Rifampicin. Isoniazid. Streptomycin.
  • 13. Second Line drugs: Fluroquinolones. Aminoglycosides (Kanamycin, amikacin, capreomycin) Ethionamide P-Amino salicylic acid Cylcoserine.
  • 15. Improving Breathing Pattern Administer and teach self-administration of medications as ordered Encourage rest and avoidance of exertion Monitor breath sounds, respiratory rate, sputum production, and dyspnea Provide supplemental oxygen as ordered. NURSING MANAGEMENT
  • 16. Preventing Transmission of Infection Be aware that TB is transmitted by respiratory droplets or secretions. Provide care for hospitalized patient in a negative-pressure room to prevent respiratory droplets from escaped when door is opened. Enforce rule that all staff and visitors use well-fitted standard dust/mist/fume masks for contact with patient.
  • 17. Use high-efficiency particulate masks, such as high- efficiency particulate air (HEPA) filter masks, for high- r_M procedures, including suctioning, bronchoscopy, or pentamidine treatments. Use standard precautions for additional protection gowns and gloves for direct contact with patient, linens :: articles in room, meticulous hand washing.
  • 18. Improving Nutritional Status Explain the importance of eating a nutritious diet to promote healing and improve defense against infection. Provide small, frequent meals and liquid supplements during symptomatic period. Monitor weight. Administer vitamin supplements, as ordered, particularly pyridoxine (vitamin B(.) to prevent peripheral neuropathy in patients taking isoniazid.
  • 19. Improving Compliance Educate the patient about the etiology, transmission, and effects of TB. Stress the importance of continuing to take medicine for the prescribed time because bacilli multiply slowly and thus can only be eradicated over a long period Review adverse effects of the drug therapy. Question the patient specifically about common toxicities of drugs being used, and emphasize immediate reporting should these occur.
  • 20. Participate in observation of medication taking, weekly pill counts, or other programs designed to increase compliance with treatment for TB.