MICRO PARA LABORATORY ACTIVITY 4: CASE STUDY 2

Names:
Alindogan, Jerickson
Ayson, Nicole Angela
Cordero, Michelle
Enriquez, Roxanne
Herico, Julianne Claire
Liscano, Sophia Joy
Tarifa, Vannesa

Case Study 2

Chief Complaint
A 10-year-old boy presents with a 3-week history of weight loss, diarrhea, vomiting, and cough.
No toxin ingestion has been noted and the family denies any use of traditional medicines.

History
A 10-year-old boy was brought into the emergency department by his mother because she was
worried about ongoing diarrhea for three weeks and vomiting following every meal. As a result,
he had lost a lot of weight and was extremely thin. She also noted that he was having difficulty
walking and sitting up, and his hands would shake as he tried to pick things up. The mother was
also worried about an ongoing cough. Although she had not noted any fever or night sweats and
the cough was non-productive, she had been infected with TB one year before. She had
completed her treatment and was now sputum negative, but the child had not received any TB
prophylaxis at the time and she was worried he may also have TB.

Past Medical History

The mother reported occasional episodes of diarrhea since age 1 year, which were treated at
her local clinic. No other illnesses or hospitalizations were noted.

Birth History
The child was born at term, with a normal vaginal delivery- no complications.
He was breast and formula-fed, until age 2 years.
The mother does not know her HIV status and was not treated with Nevirapine at the time of
delivery.

Social History
The family lives in Angeles City, in a two-bedroom house. There are 4 adults and two older
siblings aged 12 and 13, who are all reported as well. Two of the adults are employed and
support the household. Water and electricity are available in the home.

Vaccinations
Up to date
Medication
No medication
No history of any traditional medication use (orally or via enema).

Allergies
None known

Differential Diagnosis
Splenic Tuberculosis

Guide Questions:

1. What factors could have influenced the child to become infected with the disease?
Occasional episodes of diarrhea since age 1 year
● The mother does not know her HIV status and was not treated with Nevirapine at the
time of delivery.
● Mother infected with TB

2. If you were to conduct a physical assessment of the child, which systems would
you give focus? Why?

I would assess the Respiratory system, Lymphatic, and Digestive system of the
client. The assessment of us nurses helps us identify the clues which are needed for the
diagnosis of our patient. With that said the client displays the symptoms of tuberculosis which
means that the unusual weight loss and coughing are the indicators that the patient has
tuberculosis. This is why the physical assessment of systems are Digestive system, as the
patient is experiencing the unusual weight loss that could put him at risk of worsening his
situation given that nutrition is needed to fight off the disease that the client is experiencing
moreover the diarrhea that the client is experiencing is also part of the digestive system.
Moreover, the respiratory system is also the system that we need to assess as the client is
showing the symptoms of cough which can also indicate that the client has tuberculosis.
Assessing the patient's lungs should be the number one priority for us nurses to confirm that the
client has tuberculosis. The equipment that is needed for the checking of the lungs should
involve x-ray and the use of a stethoscope to identify the client’s breathing pattern. And lastly,
the lymphatic system is also involved as Mycobacterium is the cause of all the signs and
symptoms that the patient is experiencing. Moreover, in determining for the mycobacterium
there are tests that would indicate if the patient has Tuberculosis and these tests are TST or
known as Tuberculosis Skin test, and TB blood test. Knowing the systems of the body is the
best way to identify the specific disease that is affecting our body so that the health care team
shall formulate a plan that would help the patient recover from the disease that he is
experiencing.
 3. What is the appropriate health education for this case?

Common tuberculosis causes are cough, vomiting, and abdominal pain, which can
cause diarrhea and weight loss. As mentioned, his mother was diagnosed with
tuberculosis a year ago. And she had HIV when she gave birth to him. There's a
possibility a 10 yrs old boy will have T.B.He had a three-week history of weight loss,
diarrhea, vomiting, and cough.

As nurses, we must educate his mother on the possible causes wherein people
exposed to HIV are more likely to become sick with tuberculosis, especially if left
untreated. To give her a better understanding of tuberculosis. We must apply powerful
prevention to stop the spread of tuberculosis.

Washing his hands within 20 seconds is the best way to stay healthy and prevent the
spread of bacteria. He should wash his hands often, before and after eating, before and
after contact with sick people. (If you are ill, wash your hands more often to prevent the
illness from spreading to those around you. ) After contact with the animal or animal
excrement.

In addition, Environmental Infection Prevention and Control of the spread of

microorganisms are essential. The physical environment represents an important source
of pathogens that can cause infections. In addition, Taking care of their environment is a
massive help to their health to prevent any disease.

Lastly, we should apply airborne precautions to a suspected infected with tuberculosis.

Wherein can transmit from person to person through the air. using these will prevent the
spread of tuberculosis. We should brief them on what treatments we can offer to treat
his infection and do TB prophylaxis to prevent the development of active TB.one of our
duties is to make sure our patients are given proper treatment. They should be aware
that following the doctor's instructions is essential and maintaining good hygiene.

4. The parents of the child are college graduates. Your task is to conduct health
teaching to them. Which learning theory do you think would be applicable?

Constructivism Learning Theory would be the best applicable learning theory for this
matter. In this theory, learning is shaped by different concepts and understanding is being built
up by using their previous knowledge as reference . With this case, the mother went through the
same episodes as her child. As a healthcare professional, it is our job to inform and educate our
patients and their families about their condition and the health factors that come with it. With our
correct guidance, the parents should be able to reflect and incorporate their newly acquired
knowledge with their prior knowledge. According to Vygotsky, in constructivism learning theory,
students learn best when they are working collaboratively with someone whose proficiency
level is higher than their own. Working together with the parents will allow us to craft the right
treatment plan for the client. Learning is an active process and as the parents move through
their learning journey, they eventually get better at organizing information and making decisions
for their children.

5. Two (2) terms that describe infectious diseases are Communicable and
Contagious. How come some diseases are communicable but not contagious?

Although both terms are commonly used interchangeably, there is still a slight difference
between the two. All contagious diseases are communicable, but not all communicable
diseases are contagious. In general, communicable diseases are those caused by pathogens
that are spread from person to person contact, while contagious diseases are from pathogens
easily transmitted from one person to another. Communicable Diseases like syphilis is a
disease that can infect another person only if there is direct contact from sexual intercourse. An
example of a communicable disease that is contagious is the Coronavirus Disease which is a
respiratory condition that easily infects other people (whether in close contact or in the same
room) from ingesting or inhaling the particles suspended in the air and during contact with
contaminated surfaces. That is why we need to follow preventive measures to avoid getting
infected and further stop the spread of the virus.

6. One famous variant of splenic tuberculosis is pulmonary tuberculosis. It is very

common in the Philippines. Identify three (3) latest trends in either diagnosis,
treatment, or management of the disease.

● Treatment relies upon whether an individual has dynamic or dormant TB. For individuals
with idle TB, a specialist will suggest preventive treatment, which regularly includes
taking an anti-infection called isoniazid every day for 6-9 months.

● Individuals with dynamic TB normally need to take a blend of anti-infection agents for 6 a
year. First-line treatment choices incorporate isoniazid, rifampin, ethambutol, and
pyrazinamide. While certain individuals with dynamic TB require a short emergency clinic
stay, many can get treatment at home. A great many people begin feeling good and are
at this point not ready to pass on the disease following half a month of treatment.

● Notwithstanding, it is crucial to complete the full course of treatment precisely as the

specialist coordinates to hold the sickness back from repeating and to keep the microbes
from becoming impervious to the medications. Drug-safe TB is considerably more hard
to treat and can be exceptionally hazardous in the event that an individual gives it to
others.

Note: Make sure to cite the references used. Use at least 1 per item.

References:
TBFACTS.ORG (n.d.) Nutrition & TB - Malnutrition, under nutrition, assessment.

Retrieved from: https://tbfacts.org/nutrition-tb/

Villines, Z., Fisher, J. K. (2019). What to know about pulmonary tuberculosis.

https://www.medicalnewstoday.com/articles/325526

M.D. Cattamanchi, Ad., Carey, E. (2018). Pulmonary Tuberculosis.

Https://www.healthline.com/health/pulmonary-tuberculosis#diagnosis

Gately, P. J. (2020, April 18). Contagious vs infectious disease, there is a big difference.
https://www.kwtx.com/content/news/Contagious-vs-infectious-disease-there-is-a-big-difference-5
69746751.html

World Health Organization (n.d.). Coronavirus disease (COVID-19).

https://www.who.int/health-topics/coronavirus#tab=tab_1

Centers for Disease Control and Prevention (n.d.). STD Facts - Syphilis (Detailed).
https://www.cdc.gov/std/syphilis/stdfact-syphilis-detailed.htm#:~:text=Syphilis%20is%20transmitt
ed%20from%20person,%2C%20anal%2C%20or%20oral%20sex.

Kurt, Serhat. (2021). Constructivist Learning Theory

https://educationaltechnology.net/constructivist-learning-theory/

Watson, C. (2018). Hand washing: Proper technique, antibacterial soap, hand sanitizers and
more. Cleveland Clinic. Retrieved February 19, 2022, from
https://my.clevelandclinic.org/health/articles/17474-hand-washing

Marix, G. (2019). Infection control. Centers for Disease Control and Prevention. Retrieved
February 19, 2022, from https://www.cdc.gov/tb/webcourses/tb101/page1796.html

DiLonardo Mary J (2021). TB (Tuberculosis) Tests.

Retrieved from:

https://www.webmd.com/lung/tests-tuberculosis#:~:text=The%20TB%20skin%20test%2C%20al
so,small%20prick%20from%20the%20needle.