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N4127
Exam II Communicable & Infectious Disease Risk (TB)
| Question | Answer |
|---|---|
| TB is now what? | 2nd Leading cause of death worldwide from an infectious agent. |
| The increase in incidence of TB is due to what? | Multidrug-resistant strains. Institutional living facilities. Declining public health infrastructure. Increased immigration. HIV/AIDS pandemic. |
| What is the HP 2020 initative? | Curative therapy for tuberculosis Treatment for high-risk persons with latent tuberculosis infection Timely laboratory confirmation of tuberculosis cases. |
| Reported TB Cases* in United States, 1982–2006 | Shows it is on the decline |
| TB Morbidity in the United States, 2001–2006 | Shows its on the decline |
| TB Case Rates,* United States, 2006 | Shows its on the decline |
| How is M. tuberculosis transmitted? | By droplet nuclei. Close contacts at highest risk of becoming infected. occurs from person with infectious TB disease (not latent TB infection). |
| How is TB expelled? | When a person with infectious TB coughs, sneezes, speaks, or sings. |
| *Latent TB Infection? | *TST positive. Negative chest radiograph. No symptoms or physical findings suggestive of TB disease. |
| *Pulmonary TB Disease? | *TST usually positive. Chest radiograph may be abnormal. Symptoms may include one or more of the following: fever, cough, night sweats, weight loss, fatigue, hemoptysis, decreased appetite. Respiratory specimens may be smear or culture positive. |
| Groups That Should Be Tested for LTBI? (Latent TB Infection) | Close contacts of a person known or suspected to have TB. Residents and employees of high-risk congregate settings. Health care workers (HCWs) who serve high-risk clients. Medically underserved, low-income populations. |
| Other who could be tested LTBI? | Foreign-born persons from areas where TB is common. High-risk racial or ethnic minority populations. Children exposed to adults in high-risk categories. Persons who inject illicit drugs. |
| Who are Persons at higher risk for TB disease once infected? | Persons with HIV infection. Persons recently infected with M. tuberculosis. Persons with certain medical conditions. Persons who inject illicit drugs. Persons with a history of inadequately treated TB. |
| How do you Test for TB Disease and Infection? | Inject intradermally 0.1 ml of 5 TU PPD tuberculin. Produce wheal 6 mm to 10 mm in diameter. |
| What sfety meadureshould nurses follow when testng pts for TB? | Follow universal precautions for infection control. Do not recap, bend, or break needles, or remove needles from syringes. |
| Reading the Tuberculin Skin Test: When should TB reaction be read? | 48-72 hours after injection. |
| Only what should be measured? | Induration. |
| TB reaction is recorded in? | Millimeters. |
| 5 mm measurement is considered positive for what category of persons? | HIV-positive persons. Recent contacts of TB case. Persons with fibrotic changes on chest radiograph consistent with old healed TB. Patients with organ transplants and other immunosuppressed patients. |
| 10 mm is classified as positive in what categoru of persons? | Recent arrivals from high-prevalence countries. Injection drug users. Residents and employees of high-risk congregate settings. Mycobacteriology laboratory personnel. Persons with clinical conditions that place them at high risk. |
| What other gruops are 10 mm reaction of TB considered positive? | Children <4 years of age, or children and adolescents xposed to adults in high-risk categories. |
| 15 mm is classified as positive in what category of people? | Persons with no known risk factors for TB. |
| TB testing program should only be conducted among which group? | high-risk groups. |
| Tuberculin skin testing not contraindicated for whom? | BCG-vaccinated persons |
| LTBI diagnosis and treatment for LTBI considered for for whom? | Any BCG-vaccinated person whose skin test of $10 mm, & any of the following: Was contact of another person with infectious TB. Was born or has resided in a high TB prevalence country. Is continually exposed to populations where TB prevalence is high |
| Diagnosis and Evaluation for TB | Medical history Physical examination Mantoux tuberculin skin test Chest radiograph Bacteriologic or histologic exam |
| Pulmonary Symptoms of TB | Productive, prolonged cough (duration of 3 weeks). Chest pain. Hemoptysis. |
| Systemic Symptoms of TB | Systemic Symptoms Fever. Chills . Night sweats. Appetite loss. Weight loss. Easy fatigability. |
| Strongly consider TB in patients with what containing acid-fast bacilli (AFB) | Smears |
| Smear Results should be available within howlong of specimen collection? | 24 hours |
| Smear is what diagnosis to TB | Presumptive |
| What is a diagnostic confirmation for TB? | Sputum culture |
| If smear is negative, what do you do? | Culture all specimen |
| when liquid medium systems used for TB, result should be ready within? | 4 - 14 days |
| Treating LBTI will result in what? | Reduces the risk that M. tuberculosis infection will develop into TB disease |
| Who should be treated for TB also? | Certain groups with higher risk for developing TB disease after infection. |
| Before beginning treatment for LTBI, what should nurses do? | Exclude diagnosis of TB. Ensure patient has no history of adverse reactions resulting from prior LTBI treatment. |
| Candidates for LTBI Treatment? | Highest risk groups such as the Immunocompromised. Recent contacts. X-ray indicates previous TB. with result ≥5 mm |
| Candidates for Treatment for LTBI for what other group? | Other high-risk groups with result of ≥10 mm |
| Treatment for LTBI should begin with at no risks group when TB reaction result is what? | ≥15 mm |
| Drug Regimens for the Treatment of LTBI? | Isoniazid: 9 months, Daily. Isoniazid : 6months, Daily. Rifampin : 4 months, Daily. |
| Which medication generally should not be offered for LTBI? | Rifampin/Pyrazinamide |
| What are the Basic Principles of Treatment for TB disease ? | Provide safest, most effective therapy in shortest time. Multiple drugs to which the organisms are susceptible. Never add single drug to failing regimen. Ensure adherence to therapy. |
| What is the major proble of TN trestments? | Adherence |
| What measure should be taken to ensure TB treatment adherence? | DOT |
| How many drugs are currently approved for the treatment of TB disease? | 10 drugs |
| Of the Aproved 10 TB drugs, which is the first-line anti-TB agents that form the core of treatment regimens include? | isoniazid (INH). rifampin (RIF). ethambutol (EMB). pyrazinamide (PZA). |
| What Presents a difficult treatment problems for TB disease? | Multidrug-Resistant TB (MDR TB) |
| Multidrug-Resistant TB (MDR TB) should only be treated by who? | By an expert in treating MDR TB disease |
| Clinicians unfamiliar with treatment of MDR TB should do what? | Seek expert consultation |
| What are the Three priority strategies for Community TB Control Preventing and Controlling TB? | Identify and treat all persons with TB disease. Identify contacts to persons with infectious TB; evaluate and offer therapy. Test high-risk groups for LTBI; offer therapy as appropriate. |
| In what 1st three areas should Health care providers should work with health department? | Overall planning and policy development. Identification of persons with clinically active TB. Management of persons with disease or TB suspects. |
| In what 2nd four areas should Health care providers should work with health department? | Identification and management of persons with LTBI. Laboratory and diagnostic services. Data collection and analysis. Training and education. |
| What are Nurse’s Role in Providing Preventive Care for Communicable Diseases? | At all levels of prevention, the nurse functions as: Counselor. Educator . Advocate. Case manager. Primary care provider. Also Assessment and counseling individuals and family members. |
| Nurse's interventions at the community level? | Media campaigns High-risk population education and screening. Peer counseling. Partnerships with community-based organizations. Policy development. |
| STD, HIV, Hepatitis, and TB Primary Prevention? | Sexual history. Safe sex. Drug Use. Education and counseling. Community outreach. Community education. Community evaluation. |
| STD, HIV, Hepatitis, and TB Secondary Prevention? | HIV test counseling. STD testing. TB skin testing. Partner/contact notification. |
| STD, HIV, Hepatitis, and TB Tertiary Prevention? | DOT for TB. Management of AIDs. Infection Control/ Universal Precautions. |
Created by:
nze
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