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Infectious disease
Primarily affects the lung parenchyma
May be transmitted to other parts of the body including meninges, kidneys ,bones and
lymph nodes
World deadliest disease
Remains as a major public health problem in Philippines
Synonymously to the word “phthisis” and “koch’s disease”
Infectious Agent:
Mycobacterium Tuberculosis
Primary infectious agent
Acid fast aerobic rod bacilli that grows slowly and its sensitive to
heat and UV.
Divides 16 to 20 hours, extremely slow rate compared with others,
which usually divide in less than one hour.
Mode of transmission:
Airborne droplet
method through coughing, sneezing, signing, talking
Smaller than 5 microns and more than 5 feet
Principles: A larger micron settles smaller microns fly in the air and was inhaled by the
susceptible host.
Direct invasion
Through mucous membranes or breaks in the skin may occur but it is extremely rare.
Clinical Manifestation:
Close contacts with someone has active TB. Inhalation of airborne nuclei from an
infected person is proportional to the amount of time spent in the same airspace, and
proximity of the person, and the degree of ventilation.
Immunocompromised status- HIV infection, cancer, transplanted organs, prolonged high-
dose corticosteroid therapy.
Substance abuse (IV/Injection drug users and alcoholics)
Inadequate health care- homeless, impoverished, minorities, particularly children under
age 15 year old and young adults between (15 and 44 year old)
Pre-existing medical conditions or special treatment (eg. diabetes, chronic renal failure,
malnourishment, selected malignancies, haemodialysis
Immigration from countries with a high prevalence of TB (South Eastern Asia, Africa,
Latin, America, Caribbean)
Institutionalizations- long term care facilities, prisoners
Living in overcrowded, substandard housing
Occupation (health care provider)
Smoking- prolonged used of cigarettes.
INCUBATION PERIOD
From 2 to 10 weeks
PATHOPHYSIOLOGY
Infection of lungs caused by Mycobacterium tuberculosis, an acid-fast bacterium.
Causes tubercles, fibrosis, and calcification within the lungs.
Tubercle bacillus may be communicated to others by means of drop formation
(inhalation), ingestion, or inoculation.
Predisposing factors include debilitating diseases such as alcoholism, cardiovascular
disease, HIV infection, diabetes mellitus, and cirrhosis, as well as poor nutrition and
crowded living conditions.
The emergence of multi-drug-resistant tuberculosis has complicated management of
the disease.
Chronic, progressive, and reinfection phase is most frequently encountered in adults
and involves progression or reactivation of primary lesions after months or years of
latency.
Swallowing infected sputum may lead to laryngeal, oropharyngeal, and intestinal
tuberculosis.
Mycobacterium Tubercle Bacilli
Inflammation in Alveoli
Calcified Liquefaction
Cavity
NURSING CARE
1.) ISOLATION:
The pt is remove from frequently contact w/members of the family and public
It serves to prevent the spread of tubercle bacilli
Positive Sputum patient should be grouped together and negative sputum patient
should be together
The nurse must impress the pt and his family with the necessary of controlling the
spread of TB
Educate pt regarding personal hygienic but also the members of the family about the
necessary medical aseptic technique.
Proper disposal of secretions from mouth and nose should be prioritized in this
program.
Used of tissue, handkerchief, or towel when coughing or sneezing.
DRUG OF CHOICE
RIFAMPICIN- common side effects are hepatitis and febrile reaction
ISONIAZID- can cause peripheral neuritis
PYRAZINAMIDE- hyperuricemia is one of the side effects
ETHAMBUTOL- can cause optic neuritis or blindness
STREPTOMYCIN- only anti-tuberculosis drugs that is injectable
METHODS OF CONTROL
BCG vaccination after birth and at school entrants for the booster dose.
Educate the public in the mode of spread and methods of control and the importance of
early diagnosis.
Improve social risk condition, such as overcrowding
Early detection and treatment