Republic of the Philippines

UNIVERSITY OF EASTERN PHILIPPINES

University Town, Northern Samar
Website: uep.edu.ph Email: uepnsofficial@gmail.com

COLLEGE OF NURSING AND ALLIED HEALTH SCIENCES

NCM 112:
Care of Clients with Problems in Oxygenation, Fluid and Electrolytes, Infectious,
Inflammatory and Immunologic Response, Cellular Aberrations, Acute and
Chronic

PULMONARY
TUBERCULOSIS

SUBMITTED BY:

IRINCO, LIEZEL ANNE E. RASPADO, KAYETRYN G.

BSN 3-C BSN 3-D

SUBMITTED TO:

ROMEO Q. RIVERA, MSN

CNAHS Professor

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 DEFINITION TREATMENT: Similar to treatment of
Active TB disease but the duration may be
Tuberculosis (TB) is an infectious disease that
longer.
primarily affects lung parenchyma. It also may be
transmitted to other parts of the body, including
the kidneys, bones, and lymph nodes. The primary INCIDENCE/PREVALENCE
infectious agent is Mycobacterium tuberculosis
 In the United States, 9105 cases of TB were
Infection may develop when a susceptible host
reported in 2017, which is a 2.3% decrease
breathes in air containing droplet nuclei and the
from 2016 (CDC, 2018).
contaminated particle eludes the normal defenses
 In 2021, an estimated 10.6 million people
of the upper respiratory tract to reach the alveoli.
fell ill with tuberculosis (TB) worldwide. Six
million men, 3.4 million women and 1.2
million children.
4 CATEGORIES OF PTB
 In the Philippines, about 70 Filipinos die
1. Latent TB Infection – This refers to daily from TB. For every 100,000 Filipinos,
individuals who have been infected with an estimated 650 individuals were infected
TB but do not have an active TB disease. with TB in 2021, a huge difference from
TREATMENT: A daily dose of isoniazid 554 per 100,000 from the year prior.
(INH) taken as a single daily pill for 6 to 9
months. CLINICAL MANIFESTATIONS

2. Active TB disease – This refers to  Low-grade Fever

individuals who have active disease that is  Cough
susceptible to standard TB drugs.  Hemoptysis
TREATMENT: Combination of isoniazid,  Fatigue
rifampin, pyrazinamide, and ethambutol  Weight Loss
for a period of 6 to 12 months.  Sweating

3. Drug-resistant TB disease – This refers to

individuals who have active TB disease that COMPLICATIONS
is resistant to some of the standard TB  Extensive pulmonary destruction
drugs.  Acute respiratory distress/respiratory
TREATMENT: Combination of second-line failure
TB drugs for 20 to 30 months. Treatment  Chronic pulmonary aspergillosis
regimen depends on the drug
susceptibility test results of the isolate
LABORATORY & DIAGNOSTIC TEST:
4. TB disease with Extrapulmonary
involvement – This refers to individuals  Complete History
who have active TB disease that has spread  Physical Examination
beyond the lungs to other parts of the  Tuberculin Skin Test (TST)
body, such as the lymph nodes, bones, and  Chest X-ray
brain.  Sputum Culture
 Quanti-FERON Gold Test

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 NURSING DIAGNOSIS

1. Ineffective airway clearance related to

thick or bloody secretions.
2. Imbalanced Nutrition: Less than body
requirements r/t increased metabolic
needs associated with infection.
3. Risk for impaired gas exchange related to
decrease in effective lung surface.

MEDICAL MANAGEMENT

First-line drugs:

 Isoniazid (INH)
 Rifampin (Rifadin)
 Pyrazinamide
 Ethambutol (Myambutol)

Second-line drugs:

 Fluoroquinolones
 Ethionamide
 Amikacin
 Capreomycin

NURSING MANAGEMENT

1. Promoting Airway Clearance

2. Advocating Adherence to Treatment
Regimen
3. Promoting Activity and Adequate Nutrition
4. Preventing Spreading of Tuberculosis
Infection

PROGNOSIS

The majority of patients with a diagnosis of TB have

a good outcome. This is mainly because of effective
treatment. Without treatment mortality rate for
tuberculosis is more than 50%.

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4
 Secondary Infection

Compromised Immune System

Active Disease
Hemoptysis

Ghon tubercle ulcerates

Releasing the cheesy

Heals & forms scar tissue
material into the bronchi

Infected lung become more

inflamed

Bronchopneumonia & Tubercle

formation

Abscess

Lung consumption

Alveolar damage & decreased oxygen

DEATH