Nursing Care of the Tb

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Disorder: Tuberculosis

Article: Tuberculosis: A Review and Update, Radiologic Technology Journal, September/October 2010, Vol. 92/No.1

Risk Factors: People with a weak immune system, recent exposure with TB bacteria, immigration from area with high TB rates, IV drug users and people working in facilities at high risk for TB including hospitals, shelters, jails and nursing homes (Basic TB Facts, 2010).

Questions to ask Patient:

Are you having any difficulty with breathing now?
Are you having any shortness of breath?
How long have you had a cough?
Describe your cough.
Are you bringing up any phlegm? If yes, what is the color?
Does it hurt to cough?
What would you rate the pain on a scale between 1 and 10 with 10 being the worst? Is there anything that relieves the cough or pain?
Have you had any difficulty sleeping at night due to your coughing? Has anyone in your household been sick recently?
Have you been around anyone with tuberculosis?
Have you ever been diagnosed with tuberculosis before? Did you receive treatment for TB? Have you noticed that you are sweating more at night when you are sleeping?

Physical Examination Techniques:

Mask applied to patient during assessment.
Vital signs and pulse ox level obtained.
Patient’s weight compared to last doctors visit.
Auscultation/ percussion of anterior and posterior chest.
Assessment of lymph nodes.
Sputum sample obtained and sent to lab.
Tuberculin skin test administered with follow up appointment to check site in 72 hours. Patient to be sent for chest CT.

S- 35 year old male presents with lethargy, recent weight loss, night sweats and persistent cough with blood tinged sputum. He advises that he works as a security guard in a correctional facility with a high incidence of TB. He is married with two small children and is very concerned that he may have contracted TB at work.

O- Patient has persistent, hacking cough with blood tinged sputum. Vitals are stable with...
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