Pulmonary Tuberculosis - Pathophysiology and Manifestations

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Questions and Answers

What is the primary causative agent responsible for Tuberculosis (TB)?

HIV virus

Streptococcus pneumoniae

Escherichia coli

Mycobacterium tuberculosis (correct)

Which symptom is characteristic of active TB but not seen in latent TB?

Asymptomatic

Persistent cough for more than three weeks (correct)

Weight loss

Night sweats

What is one effective nursing intervention to promote medication adherence in TB patients?

Educate about the importance of medication and support systems (correct)

Reduce the number of medications prescribed

Isolate the patient from family members

Encourage self-diagnosis of side effects

Which diagnostic test is primarily used to confirm the diagnosis of TB?

Sputum culture Signup and view all the answers

How do granulomas form during the pathogenesis of TB?

Walled-off masses made by immune cells trying to contain bacteria Signup and view all the answers

Which of the following represents the primary route of TB transmission?

Airborne droplets from an infected individual Signup and view all the answers

What nursing assessment is crucial for monitoring a TB patient's respiratory status?

Listening to lung sounds Signup and view all the answers

In managing a TB patient, which procedure is essential to prevent transmission?

Education on cough etiquette and proper hygiene Signup and view all the answers

What is a primary goal of drug therapy in the management of active tuberculosis?

To ensure complete bacterial eradication Signup and view all the answers

Which symptom is NOT commonly associated with pulmonary tuberculosis?

Weight gain Signup and view all the answers

Which intervention is MOST important to prevent the transmission of tuberculosis?

Adhering to airborne isolation precautions Signup and view all the answers

What is a key component of patient education for someone diagnosed with tuberculosis?

Explaining the potential duration of treatment Signup and view all the answers

Which physical examination finding is NOT typically assessed in a patient with active TB?

Palpating for abdominal tenderness Signup and view all the answers

What is a common psychosocial support strategy for patients with tuberculosis?

Addressing emotional distress Signup and view all the answers

In managing active TB, what lifestyle modification might be encouraged?

Improving air quality at home Signup and view all the answers

What is an essential aspect of monitoring a patient on tuberculosis medication?

Monitoring for adverse drug reactions Signup and view all the answers

Study Notes

Pulmonary Tuberculosis (TB) - Pathophysiology

Tuberculosis (TB) is a chronic, infectious disease primarily affecting the lungs.
Causative agent: Mycobacterium tuberculosis.
Transmission: Airborne droplets produced by coughing, sneezing, or speaking by an infected individual.
Pathogenesis:
- M. tuberculosis inhalation leads to colonization in the alveoli.
- Macrophages engulf the bacteria but cannot destroy them completely.
- Bacteria replicate inside the macrophages, activating the immune system, leading to granulomatous inflammation.
- Granulomas (tubercles) – walled-off masses of immune cells and bacteria – form.
- They can progress from a latent infection to active disease.
- Depending on host immune response, active TB can become disseminated (miliary TB).

Clinical Manifestations

Symptoms depend on the stage (latent/active) and extent of disease.
Latent TB: Asymptomatic, but the person can transmit the disease.
Active TB: Symptoms include:
- Persistent cough (> 3 weeks)
- Coughing up sputum (may be bloody)
- Weight loss
- Fatigue
- Fever
- Night sweats
- Chest pain

Nursing Interventions

Assessment: Thorough history (exposure, symptoms), physical examination (lung sounds, vital signs).
Education: Emphasize preventive measures (cough etiquette, hygiene), medication adherence, disease transmission precautions.
Monitoring the patient's response to treatment: Observe the patient's respiratory status, including breath sounds, oxygen saturation, and chest X-rays.
Medication administration: Ensure the patient understands the importance of taking medications as prescribed, monitoring for side effects, and avoiding potential drug interactions.
Promoting adherence: Encouraging the patient to have the support of family and healthcare team in their medication regimen adherence
Collaborative care: Working with physicians, medical specialists, and nutritionists to ensure optimal patient care.
Preventing Transmission:
- Isolation procedures (e.g., airborne precautions)
- Education on transmission routes and preventive measures.

Diagnostic Testing:
- Chest X-ray: To detect infiltrates/lesions in the lungs.
- Sputum culture: To identify bacteria and confirm the diagnosis of TB.
- Mantoux test (TST) and interferon-gamma release assays (IGRAs): To detect TB infection.
Medication Management:
- Drug therapy is crucial and involves multiple medications (e.g., isoniazid, rifampin, pyrazinamide, ethambutol).
- Medications need to be taken for a prolonged period to ensure bacterial eradication and prevent drug resistance.

Patient Care Management (Active TB)

Patient Education:
- Explain the nature of the disease, its duration of treatment, medication regimen importance, and potential side effects.
Nutritional Support:
- TB patient may experience weight loss.
Psychosocial Support:
- Address emotional distress associated with a chronic illness.
- Address stigma and support coping mechanisms.

Pulmonary Tuberculosis - Clinical Assessment

History: Collecting details about recent travel history, exposure to individuals with active TB, and the presence of symptoms (e.g., cough, fever, night sweats).
Physical examination:
- Assessing for signs of respiratory distress (e.g., tachypnea, dyspnea), examining the chest (auscultation for adventitious breath sounds like crackles).
- Observing for other symptoms like weight loss, fatigue, or night sweats.

Pulmonary Tuberculosis - Nursing Interventions

Prevent transmission: Encourage patients to cover their mouth and nose when coughing or sneezing, and adhering to airborne isolation precautions.
Medication administration: Monitoring for adverse events (e.g., liver damage from certain medications) and ensuring medication adherence.
Emotional support: Addressing the patient's fears, anxieties, concerns, and providing emotional support.
Promoting adherence: Collaborating with the patient, family, and healthcare providers to create a successful treatment plan.

Pulmonary Tuberculosis - Patient Care Management & Prevention

Active TB Management: Include close monitoring of the patient's response to treatment, encouraging lifestyle modifications, and providing ongoing patient education to maintain adherence.
Prevention and Screening:
- Educate clients about the risk factors for active TB, ways to prevent it by practicing infection control measures and encourage vaccination when applicable.
- Implement screening programs to identify latent TB infections and promptly treat them to prevent progression to active TB.

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Description

Explore the intricacies of pulmonary tuberculosis, focusing on its pathophysiology and clinical manifestations. Understand the role of Mycobacterium tuberculosis, transmission methods, and the immune response that leads to the formation of granulomas. This quiz will also delve into the differences between latent and active TB.