Monday, October 17, 2011

Tuberculosis (TB) Nursing Diagnosis, Interventions, Implementation and Evaluation

Tuberculosis (TB) is an infectious disease caused by bacteria whose scientific name is Mycobacterium tuberculosis. It was first isolated in 1882 by a German physician named Robert Koch who received the Nobel Prize for this discovery. TB most commonly affects the lungs but also can involve almost any organ of the body. Many years ago, this disease was referred to as "consumption" because without effective treatment, these patients often would waste away. Today, of course, tuberculosis usually can be treated successfully with antibiotics.

There is also a group of organisms referred to as atypical tuberculosis. These involve other types of bacteria that are in the Mycobacterium family. Often, these organisms do not cause disease and are referred to as "colonizers" because they simply live alongside other bacteria in our bodies without causing damage. At times, these bacteria can cause an infection that is sometimes clinically like typical tuberculosis. When these atypical mycobacteria cause infection, they are often very difficult to cure. Often, drug therapy for these organisms must be administered for one and a half to two years and requires multiple medic
ations.
http://www.medicinenet.com/tuberculosis/article.htm 



Nursing Diagnosis and Interventions for Tuberculosis (TB)

1. Ineffective airway clearance related to increased production of secretions.

Plan objectives: to maintain patient airway, remove secretions without assistance, indicating the behavior to maintain / improve airway clearance.

Plan of action:
1) Assess respiratory function, eg, breath sounds, rhythms speed, depth and accessory muscle use.
Rational: the Ronchi, wheezing may indicate the accumulation of secretions / inability to clean Yuang airway can lead to the use of accessory respiratory muscles and increased work of breathing.

2) Record the ability to remove mucous or coughing effectively, record the character, amount of sputum, presence of hemoptysis.
Rational: spending will be difficult if the secretions are very thick, the sputum or coughing up blood caused by lung damage or brokeal requiring the evaluation / further intervention.

3) Give high semifowler position, help the patient to cough and deep breathing exercises.
Rational: breath in will increase lung expansion and reduce the effort and helps remove respiratory secretions.

4) Clean the mouth and trachea of secretions as indicated.
Rationale: prevent obstruction / aspiration.

5) Maintain the entry of fluid at least 2500 cc / day unless contraindicated.
Rational: help thin secretions.

6) Give the medication as indicated

Nursing Care Plan - Implementation
1. Increase / maintain adequate ventilation or oxygenation.
2. Preventing the spread of infection.
3. Behavioral supports to maintain health.
4. Enhance effective coping strategies.
5. Provides information about the disease process, prognosis and treatment needs.

Nursing Care Plan - Evaluation
1. Respiratory function is adequate to meet individual needs.
2. Complications prevented.
3. Lifestyle changes to prevent the spread of infection.
4. Disease process or prognosis and treatment programs is understood.

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