A nurse admitted a patient to the hospital with a possible diagnosis of active t

Question

A nurse admitted a patient to the hospital with a possible diagnosis of active tuberculosis (TB). The patient was noted on admission to have a fever of 99.9 degree F. The patient has a cough with hemoptysis. On physical examination, the nurse notes an increased respiratory rate of 24, crackles in the lungs, and a regular heart rate of 88. Describe the pathogenesis of primary tuberculosis. What other signs and symptoms should the nurse ask about during her admission history? This patient had a positive PPD 4 years ago but was found not to have active TB. What does a positive PPD mean? This patient was diagnosed with multidrug resistant TB. How would this diagnosis impact treatment and change nursing interventions?

Explanation / Answer

1. Tuberculosis which develops in primary infected people are known as primary tuberculosis. TB is caused by mycobacterium tuberculosis which is transmitted via inhalation of aerosol droplets from the infected host. As soon as the inhalation of droplet takes place, the bacteria travels to the lungs and ends up in alveoli where they are attacked by the macrophages by a process called endocytosis mediated by receptors. Mannose receptor binds to the glycolipid of the bacterial cell wall which either kills the bacteria or enables bacteria to multiply. Inside the macrophage, the bacteria replicates by blocking phagosome formation which causes bursting of macrophage leading to further infection. Granuloma gets formed in the infected areas which when necrotize leads to a mixture of sputum and blood and it heals with time with scarring and calcification.

2. Cough of 3 weeks or longer, chest pain, presence of blood in the sputum, fatigue, loss of weight, chills, loss of apetite, fever,chills,and sweating at night.

3. PPD means " purified protein derivative". It is a skin test adviced for someone suspected with a possibility of tuberculosis.

4. Multidrug resistant TB is failure of the system to respond to two most powerful anti TB drugs- isoniazid and rifampicin. This is not a good thing to be diagnosed as there are limitedand expensive options of treatment, lack of availability of recommended medicines, and adverse effects of the drugs to treat multidrug resistant TB. Nursing interventions would revolve around curing the TB patient the first time around, ensuring adequate infection control in facilities where patients are treated and appropriate use of recommended second-line drugs.

Related Questions

Navigate

• Browse (All)
• Browse A
• Subjects

---

---

Integrity-first tutoring: explanations and feedback only — we do not complete graded work. Learn more.