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A. Hypothesis
Tuberculosis is a chronic, recurrent, infection caused by Mycobacterium
Tuberculosis, M. Bovis or M. Africanum. The common TB popular in the Philippines
and other Asian countries is Pulmonary (lung) Tuberculosis due to M. tuberculosis.
TB can occur in persons of any age, although it is more common in children and in
older persons whose immune systems are weak. TB can be seen in any age group
that is immunocompromised. It may develop after inhaling droplets sprayed into the
air from a cough or sneeze by someone infected with M. tuberculosis. The TB
bacteria to become pathogenic and make a person sick will need a poor diet or a
much stressed lifestyle.
In the case of Edgardo Diaz, he has a TB of the GIT. He has a globularly
enlarged abdomen and is tender upon palpation. This is probably due to his lifestyle
before. He is a 32 year pack smoker. He started smoking at the age of 14 and
stopped only in February 2009. He usually consumes one pack per day. He also has
a familial history of asthma. Although these are not the possible direct causes, but
these may have lead to the weakening of the patient’s immune system and thus
increasing the susceptibility factor of the patient to the disease.
B. Pre-Disposing Factors
• Host
-male
-46 years old
-smoking history
-family history of asthma
• Agent
- person with existing disease from Mycobacterium tuberculosis
• Environment
-living conditions
-economic level
ECOLOGIC MODEL
HOST
-male
-46 years old
ENVIRONMENT
-smoking history AGENT
-family history of asthma
person with existing
disease from
-living conditions Mycobacterium
-economic levels
tuberculosis
A. Analysis
The agent-host-environment model is primarily used in predicting illness
rather than promoting wellness, although identification of risk factors that result
from the interaction of agent, host, and environment are helpful in promoting
and maintaining health. Because each of the agent-host-environment factors
constantly interacts with others, health is an ever changing state. Health is seen
when all three elements are in balance while illness is seen when one, two, or all
three elements are not in balance.
(Fundamentals of Nursing by Kozier 2004)
The tuberculosis bacteria form small lumplike lesions called tubercles. The
lesions contain degenerating macrophages and tuberculosis bacteria. An
immune reaction is directed against the bacteria, which causes the formation of
larger lesions and inflammation. The tubercles can rupture, releasing additional
bacteria, which infect other parts of the lung or body. A strain of tuberculosis
that is resistant to treatment with antibiotics is increasing in frequency
worldwide.
(Essentials of Anatomy and Physiology by Seely 2007)
B. Conclusion
It can be inferred in the statements above that the client is suffering from
Gastrointestinal Tuberculosis, and can plausibly be caused by the lowered
immune system of the client from the identified pre-disposing risk factors. It may
have been the damaged caused by his previous lifestyle.
C. Management
MEDICAL MANAGEMENT
All patients should receive conventional antitubercular therapy for
at least 6 months including initial 2 months of rifampicin, isoniazid, pyrazinamide
and ethambutol.
NURSING MANAGEMENT
[nursing interventions written in the care plan]