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I.

Concept of Theory
A. Definition
Tuberculosis, MTB, or TB (short for tubercle bacillus) is a common, and in
many cases lethal, Tuberculosis typically attacks the lungs, but can also affect other
parts of the body.

B. Etiology
Infectious disease caused by various strains of mycobacteria, usually
Mycobacterium tuberculosis. It is spread through the air when people who have an
active TB infection cough, sneeze, or otherwise transmit their saliva through the air.

C. Signs and Symptoms
General signs and symptoms include fever, chills, night sweats, loss of appetite,
weight loss, and fatigue.

D. Pathophysiology
The main cause of TB is Mycobacterium tuberculosis, a small, aerobic,
nonmotile bacillus. The high lipid content of this pathogen accounts for many of its
unique clinical characteristics. It divides every 16 to 20 hours, which is an extremely
slow rate compared with other bacteria, which usually divide in less than an hour.


Mycobacteria have an outer membrane lipid bilayer. If a Gram stain is performed,
MTB either stains very weakly "Gram-positive" or does not retain dye as a result of
the high lipid and mycolic acid content of its cell wall. MTB can withstand weak
disinfectants and survive in a dry state for weeks. In nature, the bacterium can grow
only within the cells of a host organism, but M. tuberculosis can be cultured in the
laboratory.
E. Supporting Data
Laboratory: LED
With the tuberculin skin test (Mantoux)
PAP tests, PCR-ICT-TB TB from sputum
F. Treatment
1. Medication
Mechanism of action of anti-tuberculosis drugs (OAT)
a. Bacterial Aktiveta
1) Extracellular
Types of drugs that work is Ripamfisin extracellular (RMP) and
streptomycin (SM)
2) Intracellular
Types of drugs that act intracellularly is Ripamfisin (RMP) and isoniazid
(INH)
b. Activity sterilization
Against the persisters (semi-dormant bacilli) kills germs metabolism slow
growth (less active / dormant germs)
1) Extracellular.
Types of drugs used are Rifampiusin (RMP) san Isoniacid
2) Intracellular.
For slowly growing bacill used Rifampicin and Isoniacid
For growing very bacill used Pyrazinamide (PRZ)
c. Activity bakteriostatis
Drugs that have activity against acid-fast bacilli bakteriostatis, to:
1) Extracellular
Is Ethambutol (EMB), Paraaminosalisiklik acid (PAS) san Cycloserine or
thiacetazone.
2) Intracellular.
May still be destroyed by INH in circumstances has occurred secondary
resistance.
II. Nursing Care Plan
A. Assessment
1) Patient Identity
Name :
Age :
Sex :
Education :
Occupation :
Religion :
Ethnic/Nationality :
Marital Status :
Address :
Room :
Date :
Register Number :
Diagnosis :
2) Gurantor Identity
Name :
Age :
Sex :
Education :
Occupation :
Religion :
Address :
Relationship :
3) Health History
a) Chief Complaint
Said patients often cough up phlegm
b) History OfnPresent illness
Patient says that she initially cough for about 1 month, because of cough
suffered long enough then Widy doctor examined in the clinic. Doctors
recommend Widy for hospitalized.
c) Past medical History
1 year ago the patient had had a cough for about 3 months. Because patients
are just ordinary people even ignore the patient's illness. 1 month ago the patient
suffered from cough back because there was blood in cough patients, the patient
went to a doctor.
d) Family medical history
4) Physical Assessment
a) General Condition
b) Head and Neck
c) Skin
d) Eye
e) Nose
5) Habitual pattern of life (Physical and Psychososial Needs)
a) Personal Hygiene Treatment
b) Nutrition and Liquid
c) Activity and Exercise
6) Diagnostic Procedure
7) Supporting Data : test, medication
B. Diagnosis
No. Diagnosis Date emerged Date cured


C. Intervention
No. Diagnosis Purpose Intervention Rational


D. Implementation
Day/Date Diagnosis Time Implementation Evaluation