It is caused by a bacterial microorganism, the tubercle bacillus or Mycobacterium tuberculosis. Because TB is a notifiable disease, any cases must be reported to the public health authorities so that contact tracing and screening can be initiated. The subsequent delay in starting treatment can facilitate the spread of the disease. TB primarily affects the lungs. Although many still believe it to be a problem of the past, pulmonary tuberculosis (TB) is on the rise. Safeguards have been set up to ensure that vulnerable people with TB receive the recommended treatment where there are concerns about adherence. The culture results will give the absolute identification of the organism and identify drug sensitivities. It is often more convenient to adopt an intermittent regimen of three times weekly medication, rather than daily treatment, when DOT has been implemented, which is just as effective. prisons, homeless shelters) carry higher risks, as well as history of HIV, diabetes mellitus, substance abuse, cancer, end stage renal disease, and smoking. 15 Case study of a patient with tuberculosis Maria Mercer Chapter aims • To provide you with a case study of a patient who has been diagnosed with pulmonary tuberculosis (TB) together with the rationale for care • To encourage you to research and deepen your knowledge of TB Introduction This chapter provides you with… The chest X-ray will usually show shadowing in the apical regions of the lungs in TB, but may also show enlargement of the hilar glands; in advanced cases, cavitation of the lungs may be detected. 2.11.2007. NURSING PROCESS: THE PATIENT WITH TUBERCULOSIS. Thorax 53: 536-548. Nursing care. Once diagnosis has been confirmed it is important to initiate anti-TB treatment, which usually consists of a combination of drug regimens to ensure that drug resistance does not occur. This initially consists of a combination of four drugs - rifampicin, isoniazid, pyrazinamide and ethambutol - that will be taken for two months while awaiting culture results and is followed by at least four months of further treatment with isoniazid and rifampicin alone (BTS, 1998). 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Find out information about Nursing care plan for tuberculosis. ‘It is vital that student nurses continue to have a voice’, Clinical Nurse Specialist - Respiratory Medicine, Department of Respiratory Medicine, Kingston Hospital. However, although treatment is extremely effective it is not without problems, such as drug side-effects and compliance issues. Most patients who develop TB are nursed at home and it is important to adopt a multidisciplinary approach to ensure a successful outcome. (2000)TB Focus (Chelsea and Westminster Hospital, December). - It is spread through droplet infection but generally requires about eight hours’ close contact for the infection to be contagious (NRTC, 2000). Although numbers have now stabilised, they are not falling. Nursing Intervention for Pulmonary Tuberculosis Disease (TB): There are different types of nursing interventions for pulmonary tuberculosis disease (TB), those are described in the below: Place the patient in a negative pressure room; Always keep the door of the patient’s room shut and place an isolation sign at a visible location. MDR tuberculosis can be primary or secondary. The continuing support of the TB nurse is crucial, as adherence is most likely to fail six to eight weeks after the start of treatment. Patients require a great deal of support during this period, as adherence to the drug regimen is the main determinant of successful treatment. Tuberculosis is an infectious disease that primarily affects the lung parenchyma. The tuberculin skin test can help identify whether the individual has been exposed to TB. With acknowledgement to Carol Hart, MBE, TB Nurse Specialist, Kingston Hospital. 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