Nursing 213

N213: Health Differences Across the Lifespan 3 Study Guide

Tuberculosis Mycobacterium tuberculosis, also known as TB, is a contagious disease that is spread when someone who has it coughs, sneezes, or breaths on someone else. Usually, for someone to catch TB, they need to be in constant and frequent contact with a patient who has tuberculosis. TB can be very hard to cure and may require long periods of several different antibiotics due to drug resistance. Also, a large number of patients with TB do not take their medications like they are supposed to. There is high incidence of TB in low income populations, jails, convalescent hospitals, and mental illness treatment facilities. Tuberculosis gets its name from where the infection occurs. The mycobacterium that causes the infection goes into the alveoli in the lungs and forms lesions, called tubercles. The infected person develops a cough that lasts for weeks or months. The incubation period for tuberculosis is an average of two to 12 weeks. People with compromised immune systems from HIV/AIDS, Autoimmune conditions, advanced age or other illnesses will almost always develop active tuberculosis if exposed. In healthy people, exposure does not necessarily mean they will develop active tuberculosis, but it may elicit a positive skin test regardless. Tuberculosis is diagnosed with a thorough assessment, skin test, and chest x-rays. Once diagnosed it is treated with an antibiotic regimen that lasts for up to one year, though sometimes as little as six months. For the first two to three weeks, TB patients are isolated until the bacterium is considered sterile from the antibiotics and no longer contagious. Patients must continue on antibiotic therapy for the full course of treatment to prevent complications, such as the spread of TB throughout the body, pneumonia, pleural effusion, drug resistance, meningitis, lung collapse, and coughing up blood. Long-term health care facilities will test all patients upon admission to a facility and nurses will be tested for TB upon any new nursing employment. This is to protect nurses and future patients in case someone has been exposed but does not show any symptoms of the infection. For example, Mr. Jones was in the admission process at XYC Convalescent Hospital. He had not yet had his TB skin testing done but complained of fevers, night sweats, and a bad cough that lasted for about six weeks. He was admitted and tested within the first 24 hours and the test was positive. The physician ordered isolation and treatment, but all the other residents and employees that came in contact with the patient needed prophylactic treatment with antibiotics as well. Signs and symptoms of tuberculosis: • Cough • Weight loss • Fatigue • Anorexia • Low-Grade Fever with spikes • Indigestion • Flu-like symptoms • Pleuritic chest pain • Dyspnea • Crackles • Hemoptysis • Night sweats

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