Nursing 211

N211: Health Differences Across the Lifespan I • • Risk for infection related to communicability of the disease • Imbalanced nutrition: less than body requirements related to chronic poor appetite, fatigue, and productive cough Nursing Intervent ons Include teaching the client to cough into tissues and dispose of them immediately into special bags, take all prescribed medication daily for 9 to 12 months. Teach client to wash hands using proper hand washing techniques and to report symptoms of deteriorating condition, especially hemorrhage. Collect sputum cultures as needed; client may return to work after three negative cultures. Place client on respiratory isolation while hospitalized. Refer client and high-risk persons to local or state health department for testing and prophylactic treatment. Client will be on standard/airborne precautions, antituberculars (Isoniazid, Rifampin), and infection-control precautions to reduce the spread of infectious organisms. Interventions also include a negative pressure room to prevent the spread of infection. Instruct the patient to cover nose and mouth when sneezing to reduce transmission by droplet. Client is maintained on standard precautions and airborne precautions. Client is in a private room with negative air pressure that has 6 to 12 full air exchanges per hour and is vented to the outside or has its own air filtration system. Wear a specially fitted mask (N95 respirator) whenever entering the client’s room. Respirator must be fit tested with each use. Provide client with a surgical mask if client is transported to another department. 2.11 First Line Medications Isoniazid (INH) interferes with the DNA metabolism of tubercle bacillus. Side effects of INH are nausea, vomiting, abdominal pain, rarely neurotoxicity, optic neuritis and hepatotoxicity. Clients require high dose of pyridoxine (vitamin B6) during therapy prophylactically. INH is used as a single agent for active TB clients. INH is the drug of choice for 12 months if abnormal chest x-ray or high risk population such as with HIV or drug induced immunosuppression. Teach client to take INH one hour before meals. INH increased Dilantin levels. Rifampin (Rifadin) has a broad spectrum effect and inhibits RNA polymerase of the tubercle bacillus. Side effects include hepatitis, febrile reaction, GI disturbance, peripheral neuropathy and hypersensitivity. Rifampin is used in conjunction with at least one other antitubercular agent. Rifampin suppresses the effect of birth control pills and can cause orange urine and causes body fluids to turn reddish orange. Ethambutol (Myambutol) inhibits RNA synthesis and is bacteriostatic for the tubercle bacillus. Side effects include GI disturbance, malaise, peripheral neuritis and optic neuritis. Side effects are uncommon and reversible with discontinuation of the drug. Ethambutol is the most common Knowledge deficit related to…

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