Question

A patient who had been living in South East Asia for the past two years has just been diagnosed with tuberculosis. He is complaining of night sweats, fatigue, and weight loss. He has a productive cough. 1. The CDC recommends screening people at high risk for TB. List at least five populations at high risk for developing active disease. 2. What is the route of transmission for tuberculosis and what isolation precautions are required while the patient is hospitalized? 3. Therapy for TB consists of several medications. What medications would you expect to be prescribed for this patient? 4. At what point will this patient no longer be considered contagious? 5. What teaching points are especially important for this patient? 6. Non-adherence to drug therapy is a major problem that leads to treatment failure, drug resistance, and continued spread of TB. The CDC recommends methods to ensure compliance with medication for all patients who have drug-resistant TB and for those who take medication two or three times every week. Identify one of those methods. 7. List at least four nursing diagnoses that apply to this patient and his family.

Answer 1

1). Tuberculosis is an infectious disease caused by the bacteria "Mycobacterium tuberculosis." The mode of transmission is through the contagious air, i.e. air borne, droplet infection. The organism can enter into the body by a contaminated droplet released during coughing, laughing, sneezing or speaking. The people at risk of developing active tuberculosis infection include,

1. Those with impaired immune system functioning such as HIV (human immunodeficiency syndrome)

2. Patients receiving immunosuppressant drugs, anti-cancer drugs (cause bone marrow suppression), and treatment for organ rejection

3. Those who had an infection with TB in the last two years

4. Those who inject drugs on a regular basis

5. Neonatal and young children