Tuberculosis
Bacterial infection by Mycobacterium Tuberculosis.
Affects lungs, joints, kidneys, brain, spine, liver. Aerobic, Acid fast bacteria
Tuberculosis
Risk factors
Long-term care residents, Inmates, Prisons, IV drug users, People with HIV, Homeless shelters, Refugees, & people living in poverty
Skin TB Test
If BCG vaccine (bacille Calmette-Guerin) will always have + PPD test. No skin test on these clients!
Read skin test in 48 to 72 hours.
If + TB, Acid fast bacilli sputum cultures (3 collections on 3 different mornings).
+ TB test: Immunosuppressed > 5 mm, With risk factors > 10 mm, no risk factors > 15 mm
Isolation
Type of isolation: Airborne isolation, N95, Close the door, Negative Pressure room.
Latent TB: There is no isolation required.
Latent TB
Normal xray & sputum cultures, Not contagious/asymptomatic, positive skin TB test and Gold test, Should receive treatment to prevent active TB.
Signs and Symptoms
The client will have Night sweats, Hemoptysis (blood in the sputum), Fever/chills, & Chest pain. The client will be no longer contagioous when the client has 3 negative sputum cultures, improved signs and symptoms, and 3 weeks of tuberculosis medications. Isolation until this occurs.
Side effects of TB Meds
Notice that most TB meds cause liver dysfunction. Liver function tests must be monitored when the client is taking these medications.
Rifampin
Liver Dysfunction (Monitor LFTs)
Turns Urine/Secretions/Sweat Orange/Red.Â
INH (Isoniazid)
Liver Dysfunction (Monitor LFTs)
Peripheral Neuropathy (Supplement Vitamin B6)
Pyrazinamide
Liver Dysfunction (Monitor LFTs)
Joint pain (Arthralgia). Gout attack due to ↑ uric acid.
Ethambutol
Liver Dysfunction (Monitor LFTs)
Optic Neuritis -Visual Impairment/loss/ check vision
Streptomycin
An antibiotic that causes tinnitus
Causes ototoxicity. Teach client to report tinnitus (ringing in the ears).
