Sputum Acid Fast Bacillus (Sputum AFB)

Definition: A staining technique to identify bacilli as acid fast. Indication: For mycobacterium tuberculosis Procedure

1. Collect specimen early in the morning before meal.

2. Offer mouth care-tap water only.

3. Wear gloves and mask to avoid direct contact with sputum particularly if hemoptysis present.

4. Ask the patient to breathe deeply and then cough up to 15-30 ml.

5. Ask the patient to expectorate the sputum in to the sterile container.

6. Offer mouth wash after collection of the sputum. (It leaves disagreeable taste)

Nursing Responsibilities: 1. The nurse will supervise collecting the first specimen to ensure that the patient demonstrates correct technique. 2. It is done for 3 consecutive days. 3. Avoid contaminating the inside of the container. 4. Label the cup and send to laboratory.

Pleurodesis
Definition: A procedure that causes the membranes around the lung to stick together and prevents the buildup of fluid in the spaces between the membranes Indication: For cases of severe recurrent pleural effusion (fluid around the lungs). To prevent the re-accumulation of fluid. Procedure Chemical

1. Chest tube is inserted near the underarm in lower chest area.

2. After several days, tube is clamped.

3. Chemical agent is injected through the chest tube into the pleural spaces.

4. Tube is unclamped and still remains attached to Pleur-e-vac.

Surgical

1. Thoracic surgeon incises chest and insert thorascope.

2. After draining the fluid, chemical agent is inserted directly on the pleural spaces.

Nursing Responsibilities: 1. It is not perform to patient with short life expectancy of several months. 2. And also not perform to patient with very low lung capacity or function. 3. Position the patient comfortably in a sitting position with good access to the chest drain and the site. 4. Check the chest drain site to ensure correct positioning of the tube. 5. Check the outer tube for excessive exudates and flush if necessary. 6. Observe for excessive pain or breathlessness. 7. Look for any leakage around the insertion site.