Nursing management of tuberculosis

Abstract Cootauco, M.B. (2008) Nurse-led rapid diagnosis and management of TB. This is an extended version of the article published in Nursing Times; 104: 32, 28-29. This article describes how a nurse-led rapid access clinic was developed with the aim of reducing new infections, providing high-quality treatment and maintaining low levels of drug resistance. It explains how it has reduced the waiting list for medical TB clinics. The clinic accepts urgent referrals that can be seen on the same day. Author Maricel Bombio Cootauco, BSc Nursing, Dip Psychology , is TB specialist nurse, Chest Clinic, St George's Healthcare NHS Trust, London. Introduction Tuberculosis (TB) is a public health issue in the UK. In the 1850s, one in four deaths was attributed to it. TB rates steadily declined through most of the 20th century and infections reached their lowest incidence in 1987 with 5,086 notified cases (Davies, 1996). However, cases are increasing again. Frequent travel and migration have made a major contribution to this increase. In 2006, 8,497 new cases were diagnosed in the UK, and the London region accounted for 44.8% of these cases (HPA, 2007). Most TB cases occur in non-UK born young adults who may be slow to access care (HPA, 2007). The World Health Organization has set up global targets to reduce the prevalence of and deaths due to TB by 50% relative to figures from 1990 by 2015 and to eliminate TB as a global health problem by 2050 (WHO, 2006). To achieve these goals, TB s...

Although the resurgence of tuberculosis in the early 1990s has largely been controlled, the risk of contracting this disease remains high in homeless persons, recent immigrants and persons infected with the human immunodeficiency virus (HIV). Purified protein derivative testing should be targeted at these groups and at persons with known or suspected exposure to active tuberculosis. Most patients with latent tuberculosis are treated with isoniazid administered daily for nine months. In patients with active tuberculosis, the initial regimen should include four drugs for at least two months, with subsequent therapy determined by mycobacterial sensitivities and clinical response. To avoid harmful drug interactions, regimens that do not contain rifampin may be employed in HIV-infected patients who are taking protease inhibitors or nonnucleoside reverse transcriptase inhibitors. To maximize compliance and minimize the emergence of mycobacterial drug resistance, family physicians should consider using directly observed therapy in all patients with tuberculosis. Persons with recent Mycobacterium tuberculosis infection (within the past 2 years) or a history of inadequately treated tuberculosis Close contacts (i.e., those sharing the same household or other enclosed environments) of persons known or suspected to have tuberculosis Persons infected with the human immunodeficiency virus Persons who inject illicit drugs or use other locally identified high-risk substances (e.g., crack ...

Description Tuberculosis (TB) or known as the White Plague during the 19thcentury, has inflicted the human race ever since. It is described as a chronic infectious disease caused by an organism called Mycobacterium tuberculosis through droplet transmission, like coughing, sneezing, or if the person inhales the infected droplet. It can be considered as primary or secondary infection depending on recovery of the client from the communicable infection. It is a reportable communicable disease and a repeated exposure to it causes a person to acquire it. According to a study conducted by Knechel, the progression of tuberculosis has several stages. • Latent Tuberculosis – It is the stage of infection when the person who had been exposed to the M. tuberculosis nuclei does not manifest signs and symptoms of the disease and do not have the capacity to infect other people. The nuclei just persist in the system in its necrotic form which could stay for a long time, not until that immunosuppression or a certain factor triggers it to become its virulent form. • Primary Pulmonary Tuberculosis – Since the most immediate location of pathogenesis of the organism is in the lungs, primary activation of disease in the pulmonary cavity is considered. It is usually asymptomatic and only identified through significant diagnostic examinations. Only the presence of lymphadenopathy is something that is indicative for its infection. • Primary Progressive Tuberculosis – It is the stage of the disease ...

The nursing management of Tuberculosis involves various aspects, including Prevention of TB involves identifying and addressing risk factors such as close contact with a person with active TB, immunosuppression, and poor living conditions. Nurses can educate patients about ways to prevent TB, such as maintaining good personal hygiene, improving ventilation in living spaces, and getting vaccinated against TB if available. Screening for TB involves identifying individuals at increased risk for TB infection or disease and conducting tests to detect TB. Nurses can perform a thorough assessment of patients to identify risk factors and recommend screening tests such as the Mantoux skin test or the interferon-gamma release assay (IGRA). Diagnosis of TB involves identifying the presence of M. tuberculosis in the patient’s body. Nurses can assist with collecting and processing specimens for laboratory testing, such as sputum samples or other body fluids. Treatment of TB involves a combination of medications, typically taken for several months. Nurses can educate patients about the importance of adhering to the medication regimen, monitor for adverse effects, and provide support to help patients complete the full course of treatment. Monitoring of TB involves regular follow-up to ensure that patients are responding to treatment and to detect any potential complications. Nurses can monitor patients’ symptoms, provide ongoing education and support, and collaborate with other healthcar...