By: Michelle Russell
 To
become familiar with the disease
process of TB
• Transmission
• symptoms
• Precautions
 Nursing
Diagnoses
 Interventions
 TB
is caused by Mycobacterium
tuberculosis (aerobic acid-fast bacillus)
 Most frequently affects the pulmonary
system
 15% experience the disease extra
pulmonary
 Transmission: respiratory droplets
through sneezing or coughing
 Active TB-
• Have symptoms
• Contagious
 Latent TB
• No symptoms
• Not contagious
• Bacteria remains in the body, but in an inactive
form
• THIS CAN BE ACTIVATED
 Subjective:
• Purulent greenish-yellowish sputum or blood
• Generalized weakness and fatigue
• Shortness of breath
• Activity intolerance
• Weight loss and indigestion
• Difficulty sleeping, chills or night sweats
• Productive or non productive cough
• Chest pain while breathing or coughing
 Objective:
• Diminished or absent breath sounds
• Cyanosis because of decreased oxygen to the
•
•
•
•
body
Difficulty breathing- strider, crackles
Fever
PPD Skin test
X-ray

Ask about their…..
• Medical history
• Social history
• Most importantly:
Ask if the patient has been
exposed to someone with TB, or
if they are a healthcare worker.
 Prevalence:
• Most commonly affects the elderly, men (age: 24-
44), and immuno-suppressed.
• 70% of all TB cases are most prevalent among
minorities in the U.S.
 Mortality:
• Tb is one of the leading causes of death among
the globe; 95% of all cases occur in countries
that lack resources and have a high rate of HIV
• 8 million cases occur yearly, and of those 3
million die
 Center
for Disease Control and
Prevention recommend the use of 4
drugs:
• Isoniazid (6 months), rifampin (6 months),
pyrazinamide (2 months), ethambutol (until
sensitivity results are known)
• If it is MDR, treatment must last for 24 months
 Monitor
response of therapy
 Provide monthly sputum specimens for
AFB smear and culture
 DOTS-directly
observed therapy, short
course
• Passive case detection using smear microscopy
• Short course of chemotherapy
• Uninterrupted supply of drugs
• Reporting and recording system to allow
evaluation
 WHO-
• TB prevention among those with HIV
 Infection
control
 Medication management
 Environmental management
 Surveillance
 Nutrition management
 Teaching: disease process
 Patient
scenario:
• 19yr old female started having a constant
headache, the doctors were having difficulty
finding the cause and by the time they did, it was
too late, her TB had turned into meningitis. Her
condition kept declining and a few months later,
she had a massive stroke. Now she is alive, and is
no longer contagious…. But she can’t talk or
walk, and is paralyzed on the right side of her
body from the neck down.
 The
patient has been hospitalized since
March (8 months)
 No longer on isolation
 Still fighting the infection and still
receiving long course antibiotics
 Taught the patient and her family about
her disease
 *she is attending physical therapy to help
her recover from her stroke
 Primary:
• Risk for infection R/T tissue inflammation and
infiltration
 Secondary:
• impaired gas exchange
• activity intolerance
• Social isolation
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