CASE SCENARIO ON OXYGENATION/ PULMONARY TUBERCULOSIS

SCENARIO: Mr. Manuell is a 21-year-old fresh graduate who lives in a shared flat with friends
and is studying Masters degree in English Literature at a local college. He is a new arrival to
the city having arrived from Malaysia in October 2009. There are six adults, including Mr
Manuel, who share a two-bedroom flat with three adults to one room. He was referred to
the Emergency Department (ED) by his flatmate with a 2-month history of a productive
cough, and occasional shortness of breath and heamoptysis, associated fevers, drenching
night sweats, loss of appetite and a 5-kg weight loss. In the last 7 days his symptoms have
worsened and warranted the admission to the isolation unit by the resident on duty in the
ED.

Physical Examination: Visible weight loss upon assessment, use of accessory muscles during
respiration, (+) clubbing of the nail beds, excessive sweating and appears weak and tired.
Patient also appears dehydrated with very dry skin.

The Resident on duty placed Mr. Manuell in the ED Isolation cubicle for further evaluation
and management. Strict Isolation precaution observed.

Pre-Work

1. Review the Pathophysiology of Tuberculosis and its Risk factors.

2. Know the different modes of transmission for Communicable Diseases
3. Identify the multi theraphy drugs given to TB patients.

Guide Questions:

1. Specify the different Personal Protective Equipment (PPE) used in the hospital and their
significance.
2. Identify relevant laboratory work up for the given case scenario.
3. Formulate a Drug study on the Multi Therapy Regimen for TB patients.
4. Provide 2 Nursing Diagnosis appropriate to the case given.
5. Discuss the proper collection of Specimen for the Sputum Exam and its importance.
6. Enumerate risk factors associated with Pulmonary TB and justify your answer.
7. Formulate health teaching plan for Mr. Manuell and discuss importance of the follow up
treatment in the primary health care after discharge.