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Immunity Concept
Tuberculosis (TB)
Exemplar
TB Disease
TB EXEMPLAR CORRELATION
TO
IMMUNITY CONCEPT
Compromised antecedents
Attribute deficits
Normal WBC and differential
Negative bacterial cultures
Soft, non-tender lymph nodes
Negative consequences
Localized or systemic infection
Chronic inflammatory response
TB EXEMPLAR CORRELATION
TO
IMMUNITY CONCEPT
Interrelated Concepts
Cellular
Regulation
Tissue Integrity
Comfort
Functional
Ability
Thermoregulatio
n
Nutrition
Coping
Age
Socioeconomic
Status
Lack of
Knowledge of
Infection
Prevention
Other Illnesses,
Drugs and Medical
Treatment
Environmental
Factors
Lifestyle
Behaviors
ASSESSMENT FOR TB
Comprehensive history
ASSESSMENT FOR TB
CLINICAL MANIFESTATIONS
Pulmonary TB (Adults)
Extrapulmonary TB
Kidney (hematuria)
Meninges (headache and
confusion
Spine (back pain)
Larynx (hoarseness)
ASSESSMENT FOR TB
Diagnostic Tests
Tuberculin skin test (TST)
Interferon-gamma release assay (IGRA)
Bacteriologic exam of clinical specimenssputum, urine or CSF for
AFB or specifically M. tuberculosis
Chest x-ray
CT scan
CLINICAL MANAGEMENT
OF TB
Nursing Interventions
Secondary prevention
Screening of close contacts of individuals newly
diagnosed with TB disease
Implementation of respiratory protection programs
and infection control measures
Evaluation of compliance with and effectiveness of
pharmacologic therapies
CLINICAL MANAGEMENT
OF TB
Nursing Interventions
Tertiary prevention
Use of nutritional and/or physical therapy
Identification/control of adverse and toxic effects of
pharmacologic therapies
Ophthalmologist (visual changes)
Audiologist (hearing changes)
CLINICAL MANAGEMENT
OF TB
Collaborative Interventions
Pharmacologic
First-line anti-tuberculosis drugs
Second-line anti-tuberculosis drugs
Analgesics (chest pain)
Nonpharmacologic
Oxygen therapy
Nutritional therapy
Surgical
Chest tube insertion (pneumothorax)
Lobectomy or pneumonectomy
SOCRATIC QUESTIONS
FOR TB EXEMPLAR
1.
2.
3.
4.
APPLICATION OF NURSING
PROCESS FOR TB
In the classroom, review the following TB Personal
Stories at the CDC website,
http://www.cdc.gov/tb/topic/basics/pers
onalstories.htm
:
Kennis Story
Marthas Story
Santos Story
Rick and Francenes Story