Tuberculosis:

Nursing interventions:
Promoting airway clearance. The nurse instructs the patient about correct positioning to facilitate
drainage and to increase fluid intake to promote systemic hydration.
Adherence to the treatment regimen. The nurse should teach the patient that TB is a communicable
disease and taking medications is the most effective means of preventing transmission.
Promoting activity and adequate nutrition. The nurse plans a progressive activity schedule that focuses
on increasing activity tolerance and muscle strength and a nutritional plan that allows for small,
frequent meals.
Preventing spreading of tuberculosis infection. The nurse carefully instructs the patient about
important hygienic measures including mouth care, covering the mouth and nose when coughing and
sneezing, proper disposal of tissues, and handwashing.
Acid-fast bacillus isolation. Initiate AFB isolation immediately, including the use of a private room with
negative pressure in relation to surrounding areas and a minimum of six air changes per hour.
Disposal. Place a covered trash can nearby or tape a lined bag to the side of the bed to dispose of used
tissues.
Monitor adverse effects. Be alert for adverse effects of medications.

Drug of Choice:
Isoniazid is used to treat tuberculosis (TB). TB is a bacterial infection which
mostly affects the lungs, but which can affect any part of your body. It is
treatable with a course of medicines which usually lasts for six months in total.

Although isoniazid is a very effective medicine, it can sometimes cause damage to

peripheral nerves (such as numbness and tingling sensations in the hands and
feet). If you are considered to be at risk of this, your doctor will prescribe you a
vitamin supplement of pyridoxine to prevent it.

Ethambutol is a medication used in the management and treatment of

tuberculosis. It is a bacteriostatic drug that inhibits cell wall synthesis. This
activity outlines the indications, actions, and contraindications for ethambutol as
a valuable agent in the treatment of tuberculosis. This activity will highlight the
mechanism of action, adverse event profile, and other key factors pertinent for
healthcare team members in treating patients with tuberculosis and related
conditions.
MERS-CoV:
Nursing interventions:
Monitor vital signs. Monitor the patient’s temperature; the infection usually begins with a high
temperature; monitor the respiratory rate of the patient as shortness of breath is another
common symptom.
Educate the patient and folks. Include the patient and folks in creating the teaching plan,
beginning with establishing objectives and goals for learning at the beginning of the session;
provide clear, thorough, and understandable explanations and demonstrations; and give
information with the use of media. Use visual aids like diagrams, pictures, videotapes,
audiotapes, and interactive Internet websites.
Reduce increase in temperature. Adjust and monitor environmental factors like room
temperature and bed linens as indicated; encourage ample fluid intake by mouth; eliminate
excess clothing and covers, and give antipyretic medications as prescribed.
Ensure patent airway. Teach the patient the proper ways of coughing and breathing. (e.g., take
a deep breath, hold for 2 seconds, and cough two or three times in succession); position the
patient upright if tolerated, and encourage patient to increase fluid intake to 3 liters per day
within the limits of cardiac reserve and renal function.
Reduce anxiety. Use presence, touch (with permission), verbalization, and demeanor to remind
patients that they are not alone and to encourage expression or clarification of needs,
concerns, unknowns, and questions; accept patient’s defenses; do not dare, argue, or debate;
converse using a simple language and brief statements; and allow the patient to talk about
anxious feelings and examine anxiety-provoking situations if they are identifiable.

Drug of Choice:

There is no specific antiviral treatment recommended for MERS-CoV infection.

Individuals with MERS often receive medical care to help relieve symptoms. For
severe cases, current treatment includes care to support vital organ functions.
Hepatitis:
Nursing intervention:
- Monitor hydration through intake and output.
- Monitor prothrombin time and for signs of bleeding.
- Encourage the patient to eat meals in a sitting position to reduce pressure on
the liver.
- Encourage pleasing meals in an environment with minimal noxious stimuli
(odors, noise, and interruptions).
- Teach self-administration of antiemetics as prescribed.
- Encourage rest during symptomatic phase, according to level of fatigue.
- Encourage diversional activities when recovery and convalescence are
prolonged.
- Encourage gradual resumption of activities and mild exercise during
convalescent period.
- Stress importance of proper public and home sanitation and proper
preparation and dispensation of foods.
- Encourage specific protection for close contacts.
- Explain precautions about transmission and prevention of transmission to
others to the patient and family.
- Warn the patient to avoid trauma that may cause bruising.
- Stress the need to follow precautions with blood and secretions until the
patient is deemed free of HBsAg.
- Emphasize that most hepatitis is self-limiting, but follow up is needed for liver
function tests.

Drug of Choice:
No specific treatment exists for hepatitis A. Your body will clear the hepatitis A
virus on its own. In most cases of hepatitis A, the liver heals within six months
with no lasting damage.
Adefovir Dipivoxil is an antiviral agent prescribed to treat hepatitis B, a chronic
viral infection of the liver in patients 12 years and above.
It is indicated for the treatment of chronic hepatitis B in adults with evidence of
active viral replication and either evidence of persistent elevations in serum
aminotransferases (alanine [ALT] or aspartate [AST]) or histologically active
disease.

Harvoni contains a combination of ledipasvir and sofosbuvir. Ledipasvir and

sofosbuvir are antiviral medications that prevent the hepatitis C virus (HCV)
from multiplying in your body. Harvoni treats specific genotypes of hepatitis C,
and only in certain people. Use only the medications prescribed for you. Do not
share your medicine with other people.