N213: Health Differences Across the Life Span 3

N213: Health Differences Across the Lifespan 3 Study Guide Further examination may reveal additional signs of lesions elsewhere in the body including lymph nodes, urinary tract, around the heart, or in the central nervous system. These are usually not found until the disease is quite advanced and early treatment can help prevent the spread of lesions. The biggest concern with the signs and symptoms of TB is the length of time the patient has been experiencing symptoms and the risk of exposure to others. This is where public health nursing can be a great resource for outbreaks of tuberculosis in communities. Health care providers are required by law to report any suspected or confirmed diagnoses of TB to the Centers for Disease Control (CDC) and the local health department within a timely manner. The county where the incident was reported will then assign a public health nurse to the patient’s case, who will take over and monitor for medication compliance, isolation precautions, and check for potential spread of the infection. Nursing assessment for tuberculosis: • Head to Toe General Assessment o Symptoms o Respiratory assessment focusing on character of cough and sputum with auscultation of breath sounds o Exposure history (employment, recent hospitalization, socioeconomic status, and living situation) • Review laboratory and radiographic data o Two or three step PPD test  Positive past testing  Positive previous chest x-ray o Chest x-ray  Ordered for all positive PPD  Ordered for positive exposures o Sputum cultures X 3 o TB blood testing (IGRA’s), interferon-gamma release essays, or (NAA) nucleic acid amplification, which are rapid TB tests that can be done in the lab Nursing diagnosis for tuberculosis: • Ineffective breathing pattern related to decreased lung capacity • Ineffective airway clearance related to increasing mucoid/mucopurulent sputum • Activity intolerance related to fatigue and poor nutritional status • Altered nutrition, low body requirements related to anorexia, fatigue, and decreased respiratory reserves • Risk for ineffective management of therapeutic regimen related to lack of knowledge of the disease process, prevention, and the need for adherence to treatment ©2017 Achieve Test Prep Page 12 of 204