CASE #3 PULMONARY TUBERCULOSIS

I. INTORDUCTION AND OBJECTIVES

TB is caused by bacteria (Mycobacterium tuberculosis) and it most often affects the lungs. TB is spread through the air when people

with lung TB cough, sneeze or spit. A person needs to inhale only a few germs to become infected. Every year, 10 million people fall

ill with tuberculosis (TB). Despite being a preventable and curable disease, 1.5 million people die from TB each year making it the

world’s top infectious killer. TB is the leading cause of death of people with HIV and also a major contributor to antimicrobial

resistance. Most of the people who fall ill with TB live in low and middle income countries, but TB are present all over the world.

About half of all people with TB can be found in 8 countries: Bangladesh, China, India, Indonesia, Nigeria, Pakistan, Philippines and

South Africa. About one-quarter of the world’s population is estimated to be infected by TB bacteria. Only 5-15% of these people will

fall ill with active TB disease. The rest have TB infection but are not ill and cannot transmit the disease. Both TB infection and

disease are curable using antibiotics.

OBJECTIVES

General Objective:

At the end of this case presentation, the nursing students will be able to obtain knowledge, skills and attitude regarding the general

condition of patient with Pulmonary Tuberculosis.

Specific Objectives:

At the end of this case study, nursing students will be able to:

Knowledge

• Identify problems present in patient.

• Formulate nursing care plan base on patient data.

• Recognize the sign and symptoms of Pulmonary Tuberculosis.

Skills

• Implement a proper nursing care for the patient in managing the signs and symptoms by following the nursing process

procedure.

• Document and record an accurate consideration in connection with the nursing diagnosis.

• Supervise the patient’s condition.

ATTITUDE

 Establish rapport to client and folks.

 Provide the best care for the patient
 Accept patient refusal to intervention and action offered.

II. PATIENT’S DATA

Biographic Data
1. Name: Reyes
2. Age: 35 yrs. old
3. Address: N/A
4. Sex: Female
5. Marital Status: Married
6. Admitting Impression/Final Diagnosis: Pulmonary Tuberculosis
 Chief Complaint
She complained of low grade fever, night sweats and loss of appetite. She also complained of chest tightness but upon
auscultation heart has no significant abnormalities.

Lifestyle
During her teenage years she was a smoker, alcohol drinker and a drug user. Since then she manifested a smoker’s cough.

Social History

PHYSICAL ASSESSMENT

Vital signs

 Temperature:38°C

 Pulse rate: 90 bpm

 Respiratory rate: 25 cpm

 Oxygen saturation: 90%

III. PAST AND PRESENT HISTORY

A month prior to admission, she experienced easy fatigability, nocturnal sweats and weight loss. She sought

consultation and she was able to have an apicolordotic X-Ray result of PTB and a Genexpert result of POSITIVE.

IV. PATHOPHYSIOLOGY

V. DIAGNOSTIC EXAMINATION RESULTS

VI. NURSING CARE PLAN

VII. DRUG STUDY

VIII. DISCHARGE PLAN

IX. REVIEW OF RELATED LITERATURE

QUESTIONS

1. Differentiate between hemoptysis and hematemesis.

-Hemoptysis is the spitting of blood that originated in the lungs or bronchial tubes. While, Vomiting blood, also called
hematemesis, is a serious condition in which blood is expelled from the mouth.

2. What is the role of Nurses in enhancing TB management?

TB nurse specialists can ensure that patients are given the correct medication and can provide support for patients and their
relatives or carers to prevent lapses in treatment.

3. What is the role of DOTS?

DOTS produces cure rates of up to 95 percent even in the poorest countries. DOTS prevent new infections by curing
infectious patients. DOTS prevent the development of MDR [multidrug resistant]. TB by ensuring that the full course of
treatment is followed.

4. What is genexpert test for TB?

 Gene-Xpert, a CBNAAT (catridge based nucleic acid amplification test) is a widely accepted diagnostic test for Tuberculosis.
This test is a rapid diagnostic test for Tuberculosis detection as well as Rifampicin resistance in direct smear negative cases.

5. What is the difference between latent and active TB?

Persons with latent TB infection do not feel sick and do not have any symptoms. They are infected with M. tuberculosis, but
do not have TB disease. The only sign of TB infection is a positive reaction to the tuberculin skin test or TB blood test. While,
Tuberculosis or TB, is the common name for a germ (bacteria) called Mycobacterium tuberculosis. Active TB disease is
contagious. That means it can be spread from one person to another. It is most often spread through the air.

6. What are the physical examination findings and laboratory results in the case supportive of the diagnosis of TB among adults.
Correlate it with the recent TB guidelines