Tuberculosis (TB) Module 2 PDF

TUBERCULOSIS (TB) Patho Cause Disease Course & Expected Findings Risk Factors Labs & Diagnostics Tuberculosis Airborne droplets inhaled→bacillus multiplies freely in bronchi/alveoli→primary infection→acquired immunity (2-10 weeks +PPD – immune response) → exudative response →forming lesions in m...

TUBERCULOSIS (TB) Patho Cause Disease Course & Expected Findings Risk Factors Labs & Diagnostics Tuberculosis Airborne droplets inhaled→bacillus multiplies freely in bronchi/alveoli→primary infection→acquired immunity (2-10 weeks +PPD – immune response) → exudative response →forming lesions in middle or lower lungs (caseation necrosis – calcification – primary lesion) → successful control = lesions resolve with little or no residual bacilli followed by “latent (hidden) TB” & possible secondary (recurring) infection later in life OR necrotic lesions liquify (fail) leading to active disease (Primary Progressive TB) – contagious only with symptoms Mycobacterium tuberculosis Most common bacterial infection worldwide Airborne, May be infected with bacillus, but not have active TB, slow onset • Persistent cough, mucopurulent sputum, blood streaks (hemoptysis) • Progressive fatigue, lethargy • Nausea, anorexia, and/or unintended weight loss • Irregular menses • Low-grade fever, night sweats, chills • Frequent contact with untreated person • Immunocompromised • Living in crowded areas • Older homeless adults • IVDU or ETOH abusers • Lower socioeconomic status • Foreign immigrants • NAA test most accurate and rapid (<2hrs) – tests secretions • Sputum culture (confirms diagnosis) - can take up to 4 weeks for valid results NUR3225 Module 2: TB Updated 8/30/2020 MR 1 Tuberculosis • Bacille Calmette Guerin (BCG) vaccine (used in other parts of the world – PPD will be positive after the vaccine, chest X-ray or blood analysis is needed • Tuberculin (Mantoux) test (PPD) – intradermal forearm injection, you may read the site after 48 hours (false negatives possible), 72 hours for best results. Measure induration (raised swollen area and NOT redness around it) of >10mm (or >5mm in immunocompromised patients). It shows exposure or latent TB. • Elderly or severely reduced immune function can present false negative • Meds Blood analysis tests (+ means infected, but doesn’t specify latent vs active) o QuantiFERON-TB Gold o T-SPOT TB o GeneXpert Omni (point of care testing) o + PPD (converter/cell-mediated immune response) or blood analysis test requires chest X-ray used to detect active TB (caseous lesions & inflammation) or old healing lesions Combination drug therapy with strict adherence • Triple antibiotic therapy ordered for active TB. NUR3225 Module 2: TB Updated 8/30/2020 MR 2 Tuberculosis NUR3225 Module 2: TB Updated 8/30/2020 MR 3 Tuberculosis Complication s & Nursing Care NUR3225 Module 2: TB Updated 8/30/2020 MR 4