Pulmonary Tuberculosis

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CHAPTER I
Introduction

Background and Rationale of the Study
Tuberculosis (TB) is an infectious disease that primarily affects the lung parenchyma caused by slow-growing bacteria that resembles a fungus. It is usually spread from person to person by droplet nuclei through the air. The lung is the usual infection site but may also be transmitted to other parts of the body, including the meninges, kidneys, bones, and lymph nodes. The primary infectious agent, Mycobacterium tuberculosis,is an acid-fast aerobic rod that grows slowly and is sensitive to heat and ultraviolet light. Mycobacterium bovis and Mycobacterium avium have rarely been associated with the development of a TB infection (Brunner and Suddarth, 2003). In healthy people, infection with Mycobacterium tuberculosis often causes no symptoms, since the person's immune system acts to “wall off” the bacteria. Tuberculosis is treatable with a six-month course of antibiotics (World Health Organization, 2013). Tuberculosis is a worldwide public health problem, and the mortality and morbidity rates continue to rise. In 2011, the largest number of new TB cases occurred in Asia, accounting for 60% of new cases globally. There were about 8.7 million people fell ill with TB and 1.4 million died from TB. Over 95% of TB deaths occur in low- and middle-income countries, and it is among the top three causes of death for women aged 15 to 44 (World Health Organization, 2013). Tuberculosis is also the leading cause of death among HIV-positive people. At least one-third of the 34 million people living with HIV worldwide are infected with TB bacteria, although not yet ill with active TB. People living with HIV and infected with TB are 21 to 34 times more likely to develop active TB disease than people without HIV (World Health Organization, 2013). The Philippines is among the 22 high burden countries for tuberculosis, according to the World Health Organization. It is the 6th leading cause of illness and the 6th leading cause of deaths among Filipinos. An estimated 200,000 to 600,000 Filipinos have active tuberculosis with 73 of them die every day. Another alarming fact is that there are about 80% of Filipinos have latent tuberculosis. In this condition, we already have the TB infection in our bodies, but the TB is still in the inactive state (Ong, 2012). Therefore, the need for further studies about the disease is very much crucial in the management of the disease as well as way of preventing it. This study anchors its curiosity in studying a case about tuberculosis, the pathophysiology, common clinical manifestation, complications, diagnostic procedures, medical-surgical management and nursing management of the disease. This will delve further into the different nursing management of the signs and symptoms as well as promote compliance in curing the disease.

Patient’s Data
A case of B.O.S., 41 years old, male, single, Roman Catholic, currently residing at Urgello Street, Sambag I, Cebu City, Cebu was admitted for the first time at Vicente Sotto Memorial Medical Center (VSMMC) on November 7, 2012 at approximately 5:35pm with complains of cough with blood-tinged sputum. He is unemployed. Patient has a family history of asthma in both parents. Patient is smoker. He drinks alcohol occasionally. Patient admits that he was using prohibited intravenous drugs for the past 12 years. Patient has no known food and drug allergies. Patient is 5 feet and 5 inches tall and weighed 45 kg during admission. Patient is smoker alcoholic drinker. No known food and drug allergies. Patient usually sleeps at 9pm and wakes up at 6am without afternoon naps. Patient was a carpenter and lives with his wife.

History of Present Illness
2 years before, patient was admitted at Vicente Sotto Memorial Medical Center (VSMMC) and was diagnosed with asthma. He was advised by the doctor to stop smoking and yet failed to follow. He was also using prohibited intravenous drugs and admits that they share...
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