Nursing Care Plan for Tuberculosis TB

Tuberculosis (TB) is a bacterial infection caused by a germ called Mycobacterium tuberculosis. The bacteria usually attack the lungs, but they can also damage other parts of the body. TB spreads through the air when a person with TB of the lungs or throat coughs, sneezes or talks. If you have been exposed, you should go to your doctor for tests. You are more likely to get TB if you have a weak immune system.

Symptoms of TB in the lungs may include

• A bad cough that lasts 3 weeks or longer
• Weight loss
• Coughing up blood or mucus
• Weakness or fatigue
• Fever and chills
• Night sweats

If not treated properly, TB can be deadly. You can usually cure active TB by taking several medicines for a long period of time. People with latent TB can take medicine so that they do not develop active TB

Centers for Disease Control and Prevention

Nursing Care Plan for Pulmonary Tuberculosis

Nursing Assessment

1. IdentityThe assessment includes name, age, sex, religion, ethnicity, education, employment and housing clients. In addition, it is necessary also reviewed the name and address of responsible person, and its relationships with clients.
2. History Formerly Disease
   Review the history of the disease who had suffered from childhood to adulthood, including the experience of surgery or injury resulting from accidents, it is important to expose the client health issues that may cause more severe complications of the disease is tuberculosis.
3. Disease History Now
   • Main Complaint
     Complaints night fever, night sweats, coughing up phlegm / bleeding, difficulty breathing, fatigue, night sweats, decreased appetite, weight loss.
   • History of Disease
     How long illness experienced, the things that lighten / aggravate the disease.
   • Efforts taken to resolve complaints.
4. Health Patterns
   1. Activity / Rest
      Clients may experience areduction in weakness ,shortness of breath due to work, difficulty sleeping at night ,night fever ,chills or sweating . Characterized by muscle weakness, pain, and shortness (advanced stage).
   2. Ego Integrity
      Clients can experience stress, financial problems, feeling helpless / hopeless marked denial, anxiety, fear, easily aroused.
   3. Nutrition / fluid
      Clients may complain of poor appetite, unable to digest, weight loss. Marked by poor skin turgor, dry / scaly skin, loss of muscle / subcutaneous fat loss.
   4. Pain / Leisure
      Increased chest pain due to recurrent cough, marked behavioral distraction and anxiety.
   5. Respiratory
      Clients complain of cough, productive or non-productive, short breath, a history of tuberculosis or exposure to an infected individual. Characterized by increased frequency, deaf percussionist and a decrease fremitus, breath sounds: decreased, tubular and / or pectoral whisper above the lesion area. Krekels recorded over the lung during inspiration stale quickly after a short cough. Characteristics of green sputum / purulent, mukoid yellow, or blood spots, mental changes (advanced stage).
   6. Social interaction
      Clients feel isolated / rejection due to communicable diseases, unusual patterns of change in responsibilities or change in physical capacity to perform the role.
   7. Counseling / learning
      Characterized by a family history of suffering from tuberculosis, the general inability / poor health status, failed to improve / recurrence of disease and do not want to participate in therapy.
   (Doenges, 2000, p. 240-241)

Nursing Diagnosis for Pulmonary Tuberculosis

1. Ineffective Airway Clearance related to :
   • thick secretions
   • weakness, bad cough efforts
   • edema, tracheal / pharyngeal
2. Impaired Gas Exchange related to :
   • reduced effectiveness of lung surface
   • atelectasis
   • alveolar capillary membrane damage
   • thick secretions
   • bronchial edema
3. Risk For Infection and spread of infection related to :
   • decreased immune system
   • cilia function declines
   • secretions that settle
   • tissue damage due to the spread of infection
   • malnutrition
   • contaminated by the environment
   • lack of knowledge about infectious germs
4. Imbalanced Nutrition Less than Body Requirements related to :
   • fatigue
   • coughing frequently
   • the production of sputum
   • dyspnea
   • anorexia
   • impairment of financial capability
5. Knowledge Deficit : about the condition, treatment, prevention relating to :
   • nothing is explained
   • wrong interpretation
   • the information obtained is incomplete / inaccurate
   • lack of knowledge / cognitive.