TB

Thursday, June 18, 2020 10:59 AM

Audio 1

Audio recording started: 11:57 AM Monday, June 22, 2020

Highly communicable disease caused by Mycobacterium tuberculosis

Improper, noncompliant use of treatment programs
Risk factors
Alcoholism; drinking unpasteurized milk from infected cow; younger and
older clients; clients who are homeless and from lower socioeconomic
group; crowded living conditions; intravenous drug user; malnutrition
Transmission: Airborne route by droplet infection
After infected individual has received TB medication for 2 to 3 weeks, risk of
transmission reduced greatly

Mantoux test
No risk factors - 15

An induration of 5 mm is considered a positive test for immuno-

compromised clients.
Ex: HIV Patients, oncology pts, long term corticosteroid ( > than six weeks),
Organ transplant recipients
A positive Mantoux test indicates that the client has developed an immune
response to TB – NOT a confirmation of active disease
An induration (palpable, raised, hardened area) of 10 mm or greater in
diameter indicates a positive skin test.
A positive Mantoux test indicates that the client has developed an immune
response to TB – NOT a confirmation of active disease
An induration (palpable, raised, hardened area) of 10 mm or greater in
diameter indicates a positive skin test.
Ten mm or more is positive in: Recent arrivals (less than five years) from
high- prevalence countries, Injectable drug users, Residents and employees
of high-risk congregate settings (e.g., prisons, nursing homes, hospitals,
homeless shelters, etc.), Mycobacteriology lab personnel, Persons with
clinical conditions that place
them at high risk (e.g., diabetes, leukemia, end-stage renal disease, chronic
malabsorption syndromes, low body weight, etc.), Children less than four
years of age, or children and adolescents exposed to adults in high-risk
categories, Infants, children, and adolescents exposed to adults in high-risk
categories.
False positives- Need chest x-ray to see active TB infection.
The nurse finds an area that is not heavily pigmented and is clear of hairy
areas or lesions that could interfere with reading the results.
Reinforce to the client the importance of returning for a reading of the
injection site by a health care personnel within 48 to 72 hr. Advise client not
to scratch site, avoid washing site

Medications Combination therapy – 6 to 12

months
Hepatotoxic : Advise the client to report yellowing of the skin, pain or
swelling of joints, loss of appetite, or malaise immediately. Antibiotic
property
Isoniazid (Nydrazid) : (INH) : This medication should be taken on an empty
stomach. Monitor for hepatotoxicity and neurotoxicity, such as tingling of
the hands and feet. Vitamin B6 (pyridoxine) is used to prevent neurotoxicity
from isoniazid.
Rifampin (Rifadin): Inform the client that urine and other secretions will be
orange. Inform the client this medication may interfere with the efficacy of
oral contraceptives.
Pyrazinamide: Take with a glass of water
Ethambutol : suppress RNA synthesis. Optic neuritis: Can affect vision- need
eye check up
Streptomycin : Nephrotoxic and ototoxic, Report oliguria, KFT, tinnitus,
Drink lots of fluids
eye check up
Streptomycin : Nephrotoxic and ototoxic, Report oliguria, KFT, tinnitus,
Drink lots of fluids