Tuberculosis (TB) Lecture Notes

Introduction

• Presenter: Cathy with Level Up RN
• Topic: Tuberculosis (TB)
• Format: Lecture followed by a quiz

Overview of Tuberculosis

• Disease Type: Infectious lung disease
• Causative Agent: Mycobacterium tuberculosis
• Transmission: Airborne

Pathophysiology

• Infection Process: Bacteria adheres to alveoli, triggering an immune response
• Resulting Condition: Development of granulomas or lesions in the lungs

Symptoms of TB

• Persistent cough (>3 weeks)
• Purulent or bloody sputum
• Unexplained weight loss
• Night sweats
• Lethargy

Screening and Precautions

• Screening: Symptoms are checked during hospital admission
• Precautions: Airborne precautions if symptoms are present

Diagnostic Tests

1. Quantiferon Gold Blood Test
2. MANTU Skin Test
   • Procedure: Intradermal injection
   • Reading induration:
     • ≥10 mm: Positive (active or past infection)
     • ≥5 mm in immunocompromised: Positive
   • Note: False positives possible with BCG vaccine
3. Acid-Fast Bacilli Culture
   • Performed using three early morning sputum samples
4. Chest X-Ray
   • Used to identify active lesions in the lungs

Treatment

• Approach: Combination drug therapy
• Duration: Long-term, possibly up to a year
• Medications:
  • Rifampin
  • Isoniazid
  • Pyrazinamide
  • Ethambutol
  • Mnemonic: "Ripe Orange" (Ripe = Rifampin, Isoniazid, Pyrazinamide, Ethambutol)
  • Side Effect: Orange discoloration of secretions with Rifampin

Nursing Care

• Room Requirements: Negative airflow room
• Protective Gear: Wear N95 mask
• Patient Protocol: Patient wears surgical mask when leaving room
• Family Screening: Screen family for TB due to contagiousness
• Monitoring: Regular sputum samples every few weeks
• Infection Clearance: Three negative sputum cultures required to be considered non-infectious

Quiz Questions

1. MANTU Skin Test: Induration of 10 mm indicates a positive result (5 mm in immunocompromised)
2. Antibiotics for TB: Rifampin, Isoniazid, Pyrazinamide, Ethambutol
3. Infectious Status: Requires three negative sputum cultures to be considered non-infectious (not one)

Conclusion

• Engagement: Feedback requested on quiz effectiveness
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