Infectious Conditions of the Lower Respiratory Tract

TuberculosisTuberculosisSupportive Educative NursingSupportive Educative Nursing

Etiology

• Gram + AFB• Exposure repeated• Contamination• Replication

Statistics

Video

http://www.youtube.com/watch?v=QgVchBERVng

Populations At Risk

Symptoms

Diagnosis• Tuberculin skin test• H & P• CXR• Sputum collection • + AFB• QuantiFERON-TB test

Mantoux tuberculin skin test

• Intradermal wheal• Induration 48 to 72

hours • Annually for healthcare

workers

Medical Management• Four drug regimen for six months (Centers for Disease

Control): INH (isoniazid) Rifampin PZA (pyrazinamide) Ethambutol • Follow up CXR• Follow up bacteriostatic studies

Nursing Management• Health Promotion• Education• Hand washing• Isolation• HEPA ( High-efficiency

particulate air) masks• Public/community health

department

Vaccine & ImmunizationsTB Vaccine (BCG)• BCG, or bacille Calmette-Guérin, is a vaccine for TB disease. • Not widely used in the United States• If you were vaccinated with BCG, you may have a positive

reaction to a TB skin test.

(Centers for Disease Control website)

Nursing Diagnosis• Ineffective breathing pattern r/t decreased lung capacity• Imbalanced nutrition: less than body requirements r/t chronic

poor appetite, fatigue, productive cough• Noncompliance r/t lack of knowledge of disease process• Ineffective health maintenance r/t lack of knowledge about

disease process and therapeutic regimen• Activity intolerance r/t fatigue, decreased nutritional status,

chronic febrile episodes