First Aid Nursing Branch / second stage

Critical nursing

Tuberculosis (TB)
‫آيات عبدهللا لفته‬ ‫احمد سليم جبار‬
 Introduction
 Tuberculosis: It is an infectious disease primarily caused by
Mycobacterium tuberculosis.
 it mainly affects the lungs (pulmonary tuberculosis) but can attack any part
of the body (extrapulmonary tuberculosis).
 Tuberculosis is caused by bacteria transmitted from one person to another
through microscopic droplets released in the air.
 This can happen when exposed to coughing, talking, sneezing, spitting,
laughing or singing of a person infected with the active type of tuberculosis
and has not been treated for it.
 Types of tuberculosis
1. Latent TB infection: The bacteria in this type are latent and inactive, so the patient
does not show any symptoms despite the body harboring the bacteria that cause
tuberculosis.

 The patient in this case is not contagious and does not transmit the disease to others. But
in cases where the immune system is weakened, the latent bacteria can turn active.

 It is estimated that 90% of active cases in adults come from cases with latent
tuberculosis.
2. Active TB infection: bacteria spread and multiply when the TB infection is active, and
the patient shows symptoms and is a transmitter of the infection to other people.
 Risk factors
• Close contacts of a person with infectious TB disease
• HIV infection (the virus that causes AIDS)
• Diabetes mellitus
• Severe kidney disease
• Low body weight
• Head and neck cancer
• Medical treatments such as corticosteroids or organ transplant
 Signs and Symptoms
Those with active TB can show any of the following symptoms:
1. Bad cough (lasting longer than two weeks).
2. Coughing up blood or sputum (mucus).
3. Fatigue or weakness.
4. Loss of appetite.
5. Weight loss.
6. Chills.
7. Fever.
8. Night sweats.
9. Headache, fever, stiff neck, and drowsiness with tuberculous meningitis
 Complications
1. Respiratory failure. Respiratory failure is one of the most common complication of
pulmonary tuberculosis.
2. Pneumothorax. Pneumothorax becomes a complication when tuberculosis is not
treated properly.
3. Pneumonia. One of the most fatal complications of tuberculosis is pneumonia as it
could cause infection all over the lungs.
 Diagnosis of TB
• Chest x-ray

• CT or MRI scan

• Skin tests (purified protein derivative [PPD]

• Sputum examination

• Blood test
 Diagnosis of TB
• Skin tests (purified protein derivative [PPD]
 Nursing diagnosis
1. Risk for infection related to inadequate primary defenses and lowered resistance.

2. Ineffective airway clearance related to thick, viscous, or bloody secretions.

3. Risk for impaired gas exchange related to decrease in effective lung surface.

4. Activity intolerance related to imbalance between oxygen supply and demand.

5. Imbalanced nutrition: less than body requirements related to inability to ingest Adequate

nutrients.
 Nursing Interventions
1. Promoting airway clearance: The nurse instructs the patient about correct positioning to
facilitate drainage and to increase fluid intake to promote systemic hydration.
2. Adherence to the treatment regimen: The nurse should teach the patient that TB is a
communicable disease and taking medications is the most effective means of preventing
transmission.
3. Promoting activity and adequate nutrition: The nurse plans a progressive activity schedule
that focuses on increasing activity tolerance and muscle strength and a nutritional plan
that allows for small, frequent meals.
4. Preventing spreading of tuberculosis infection: The nurse carefully instructs the patient
about important hygienic measures including mouth care, covering the mouth and nose
when coughing and sneezing, proper disposal of tissues, and hand washing.
 Tuberculosis prevention
First- Protecting healthy people from tuberculosis:
1. You should stay away from people with tuberculosis.
2. If you are thinking of traveling to an area or country where the disease is endemic,
consult your doctor.
3. Maintain safety standards, such as not using others' personal items, and wearing a mask
that covers the face and nose
 Tuberculosis prevention
Second – people infected with tuberculosis:
1. Tuberculosis patients must complete the full treatment prescribed by the doctor. Even if
the patient feels better or the symptoms subside, the tuberculosis patient must continue
treatment, as stopping it leads to the emergence of resistant strains of tuberculosis in the
infected person, which becomes more difficult to treat, and its transmission to healthy
people will pose a greater health risk.
2. Follow general hygiene guidelines, which include using only your personal items, and
covering your mouth and nose when sneezing, coughing and yawning.
3. If the doctor asks you to stay at home for a certain period, stick to it, and this is in order to
reduce the possibility of transmitting the infection to others.
THANK YOU
For attention