Tuberculosis drug treatment regimens must always include a minimum of drugs.
Added by Cynthia B.
Step 1
--- ** Show more…
Show all steps
Your feedback will help us improve your experience
Josee Pacheco and 59 other Nursing educators are ready to help you.
Ask a new question
Labs
Want to see this concept in action?
Explore this concept interactively to see how it behaves as you change inputs.
Key Concepts
Recommended Videos
Case Study Diagnosis and Treatment of Mycobacterium tuberculosis Patient Background: Patient A is a 30-year-old male who was admitted to the hospital from home after 1 week of cough, profuse nocturnal sweating, loss of appetite, and hyposomnia. He was seen by an emergency room physician who noted signs of depression. The patient has a history of intravenous drug abuse and hepatitis B. Vitals Temperature: 38.0ºC Heart rate: 110 beats per minute Blood pressure: 130/76 Respiratory rate: 20 breaths per minute Oxygen saturation of 98% on room air Physical · General: young male, looks older than stated age · HEENT: depressed, pupils equally round and reactive to light and accommodation · Neck: supple · Respiratory system: unilateral (left side) crepitation · Cardiac system: regular rate and rhythm, no murmurs, rubs, or gallops · Abdominal system: slightly distended · Extremities: no edema · Skin: excoriated, otherwise normal · Neurological system: slightly altered, but the baseline Labs Na: 133 Creatinine: 1.8 K: 4.1 WBC: 9.48 x 109 /L Cl: 96 Hgb: 11.4 g/dL (114 g/L) Platelets: 149 x 109 /L HIV test: Negative Radiology Chest X-ray showed infiltrate in the middle of the left lung with a diameter of 1.7 cm with signs of cavitation. Microbiology · General Blood Culture: No growth at 5 days · Sputum Smear Gram Stain: 4+ squamous epithelial cells, 1+ segmented neutrophils, no organisms · AFS (acid-fast stain): No organisms · Sputum Culture: No growth at 48 hrs · MGIT (mycobacteria growth indicator tube): Negative Diagnosis: Infiltrative TB of the left lung with cavitation without MTB shedding. Treatment Patient A was originally administered isoniazid, rifampin, pyrazinamide, and ethambutol for 7 days per week for 8 weeks, followed by isoniazid and rifampin 7 days per week for 24 weeks. After two months, he returned to the hospital, concerned that he had been “coughing up blood” over the previous 3 days. In addition to hemoptysis, he revealed that, since his previous visit, he had continued to feel malaise, was continuing to lose weight, and had been experiencing night sweats. The emergency room physician immediately transferred the patient for isolation in a local hospital. A repeat chest radiograph revealed progressive bilateral fibronodular disease with a “military” pattern. The patient was given a 20-month regimen of levofloxacin, kanamycin, cycloserine, pyrazinamide, and prothionamide. Following the completion of therapy, closure of the destruction cavity was found with local pneumofibrosis. Diagnosis and Treatment of Mycobacterium tuberculosis Review the microbiology tests performed in the case study, what is a biochemical media test discussed in the lecture that could have also helped identify M. tuberculosis? What is the biochemical mechanism of this media test? What are some rapid diagnosis methods discussed in the case study for mycobacterium culturing? What is a limitation/drawback of this method? What is a diagnostic test described by the case study that can detect mycobacterium without culturing? Describe how this diagnostic test works. Would this be preferred over traditional culturing, why or why not? How is multi-drug resistant tuberculosis (MDR-TB) treated? Research the key drug involved in treatment, what is its mechanism of action?
Josee P.
Mr. R is a migrant worker who has been in the United States for 6 months. He has been doing odd jobs, one of which has been cleaning chicken houses. While he is waiting for official citizenship papers, he has been unable to obtain permanent housing. He went to the health department when he could not stop coughing. He has lost 10 pounds in the last month and just does not feel well. What additional information would be helpful? He speaks and understands very little English, and his native language is Spanish. He has been staying in the homeless shelter since his arrival, and he denies any significant health issues. Is it significant that he has been cleaning chicken houses? Why or why not? A tuberculin skin test was administered, and 2 days later, there is 14 mm of induration. How would the nurse interpret his TB skin test? How will a definitive diagnosis of TB be made? What are some risk factors for TB? A diagnosis of tuberculosis is confirmed in Mr. R, and he is prescribed a combination of drugs for at least 6 months. What is the rationale for multiple drugs and the length of treatment?
Adi S.
nurse is preparing to administer morning medications to a patient who has been newly diagnosed with tuberculosis. The patient asks. "Why do I have to take so many different drugs?" Which response by the nurse is correct? "Taking multiple drugs is recommended because more drugs are becoming resistant to TB drug therapy" • "Using multiple drugs enhances the effect of each drug." • "Your prescriber hopes that at least one of these drugs will work to fight the tuberculosis." • "Using more than one drug can help to reduce side effects."
Ronald P.
Transcript
18,000,000+
Students on Numerade
Trusted by students at 8,000+ universities
Watch the video solution with this free unlock.
EMAIL
PASSWORD