Night sweats

Coughing 3 weeks or more

Chest pain

Unintentional eight loss

Coughing blood

Immuno compromised

Tired

Fever

 






Tuberculosis





Tuberculosis is also known as TB and is an infectious disease that mostly affects your lungs. TB is generally found in communities with lower income, bad living conditions or people with compromised immunity. 


Preventable and curable

 

Cause: Mycobacterium Tuberculosis

Virus/Bacteria? Bacteria

Spread by: Expelled droplets from a person with active TB sneezing or coughing 

Immunisation? Yes, a vaccinefor tuberculosis disease is called Bacille Calmette-Guérin (BCG) and it lasts around 20 years.

Important - The immunization is given intradermally. 

Notifiable? Yes

Higher risk persons: Persons with Human Immunodeficiency Virus

                                 Children and infants

 


TB Infection Summary:

TB is caused by a bacteria called Mycobacterium Tuberculosis. The bacterium spreads to the lungs and causes active tuberculosis which means it is contagious. But TB can also damage other body parts as well. TB in South Africa is often accompanied by other seious illnesses, and can be cured and preventable. The most important consideration for nursing TB patients, is education on improving their immunity and taking the medication correctly. Stopping medication halfway causes strong resistance to the medication, so the patients need to be encouraged to keep taking the medication and consulting a doctor if the side effects affect their way of life. 


TB Symptoms:

  • A bad cough that lasts a few weeks
  • Coughing up blood
  • Chest pains
  • Loss appetite
  • Unintentional weight loss
  • Tiredness
  • Fever
  • Night sweats
  • Chills 

If you know someone with these symptoms, consult a medical practitioner or clinic as soon as possible. Diagnosis is made with a sputum sample (spitting into a tube), X rays (which show white spots on the X-rays) and blood might also be drawn. 


Treatment:

Medication: The Tuberculosis drugs are critical to take and the course needs to be completed to prevent resistance. Drugs have to be prescribed by a doctor, and there is a lot of drug interaction. This means that medicines form a shop could stop the TB meds from working, or increase their toxicity.


The most common medications used:

  • Isoniazid
  • Rifampin (Rifadin, Rimactane)
  • Ethambutol (Myambutol)
  • Pyrazinamide

 Nursing care for Tuberculosis:

* Training, Education and Caring is Key. 

This is one of the biggest criteria in preventing and understanding the disease, together with the immunisation against TB

Educational points:

• Take your TB medication as it is prescribed. Don’t stop taking them because you do not feel as sick. They still need to work to get rid of the TB bacterium
• Take your medicine with food.
• Cover your mouth when you sneeze/cough. After, throw the tissue away in a covered container.
• Avoid public areas such as buses, taxi’s and closed areas until you have been told that you rent able to spread TB
• Don’t drink alcohol. Alcohol may interfere with your medicine and has effects.
• Take your medicine at the same time every day.
• Set a reminder alarm.
• Use a pillbox if it is available.
• Keep a calendar for when you take your medicine.


Complications: 

  • Certain variations can cause joint damage and pain
  • Spinal pain.
  • TB can cause meningitis. This can cause long lasting headaches and behavioural changes.
  • Liver or kidney can be damaged


Rare complications: Seldom does the heart tissues get affected. But this does cause heart disorders as it stop the heart from functioning correctly.


Prevention: Boost your immunity

• Take all of your medicines that are prescribed to you
• Cover your mouth a tissue when you cough or sneeze. Seal the tissue in a plastic bag, then throw it away.
• Wash your hands after coughing or sneezing.
• Don’t let other people visit you.
• Stay away from work, school, and other public places.
• Move around fresh air by opening a window.
• Don’t use public transportation.


Nursing care continued:

  • Allow patient to sleep in semi - fowler's ie raised position
  • Keep the patient hydratedm but not over hydrated especially if there is an infusion in place. The lungs are already battling and excesses fluid will cause more strain on the llungs, and this follows through to the heart. 
  • Keep tissues close by for coughing up blood
  • Dont touch any blood or sputum, show the family how to get rid of infected tissues etc in a plastic bag without touching the items and washing hands before and after dealing with the patient. 
  • Patients are tired, as might the family be with the night coughing. Separate the patient as far as possible. If there is a separate room for them to sleep in comfortably to allow family to not be in constant direct contact and get some sleep. Allow patient rest periods during the day. 
  • Patients with headaches will need pain medication which should be given on Dr's prescription. TB meds take a heavy toll on the liver and this will be exacerbated by paracetomol causing toxic levels and more liver damage. 
  • Joint pain - warm blankets and compresses might help with relieving pain on the joints. 
  • Correct eating can help to build immunity. Community gardens go a long way in providing essential vitamins and minerals for those that couldnt afford it. 

    

Suggested food which can grow easily 

  • Tomatoes - high in vic C and anti oxidants. Even cooked, tomatoes are great nutrition
  • Spinach/Swiss chard - easy to grown in a small area, rich in iron when taken with vit C (from the tomatoes!) full of roughage 
  • Beans -  rich in protein, giving nitrogen back to the soil instead of depleting resources
  • Rooibos tea - South Africans are blessed to have this as a heritage in the country. A proven high oxidant tea, this is full of goodness for the patient. Other teas are also full of anti-oxidants and a far better choice than coffee
  • Fish - expensive, but sardines are relatively cost effective, and full of omega oils, easily absorbed protein. Avoid if there is a history of allergies to fish. 
  • Pumpkin -This has starch, beta carotenes, Vit A, and plant sugars which can help to fill the patients. In areas in SA, the leaves from the butternut or pumpkin which is similar to cabbage which are also eaten, the seeds contains omegas.   
  • Loss of appetite mean that good foods need to be prioritised over processed eg rather eat eggs and whole wheat /brown bread than white bread. 
  • Treatment plans for a patient with TB needs to be cost effective, within the availability of the person and easy to do to improve patient compliance!!


PROTECT 

PREPARE

EDUCATE

CARE

Nursing Info South Africa

SANC eRegister

SANC fees

Nursing education RSA

Disclaimer: 

This site in no way substitutes medical advice given by a
medical practitioner and is meant as supporting information only.
The information is not intended for harm, to be seen as diagnosis,
or treatment but is infomrational only. Harm may result in ignoring medical
help and treatment, or in the neglecting of the medical treatment given/suggested
to you by your medical practitioner. The staff of the website intend the information
as informational  and supportive only,
and do not endorse self medication or ignoring medical advice.