Question

DISCUSSION (APA reference is required)

Direction:Do not answer questions directly ,WRITE one to two paragraphs

Wilson is a 36-year-old migrant worker. He was admitted to the Hospital with a cough, unintended weight loss, and night sweats. He is staying with 6 friends in a one bedroom apartment near the strawberry field where he works. The ED physician suspects Tuberculosis (TB).

What diagnostic testing will the Provider order to confirm a diagnosis of TB?

What Isolation precautions do you expect to be put in place and why?

Describe the recommended treatment regimen for TB, including the rationale for combination drug therapy.

Identify the reason compliance to medication therapy is often a concern in the patient with TB.

What should be done for Wilson's 6 roommates?

Answer 1

Tuberculosis is a multisystemic infectious disease caused by mycobacterium tuberculosis. TB may occur either as a latent or active form. The definitive diagnosis of TB is based on culture of mycobacterium from sputum. Along with history collection and physical examination a skin test termed mantoux tuberculosis skin test should be done. Another test IGRA ( interferon gamma release assays) to measure the immune response. Moreover chest X-ray, sputum smear test need to be done.

As TB is a airborne infection, transmitted by airborne droplet nuclei people with this infection should be in special isolation room where air is gently sucked out and not allowed to flow into the hallway.

Treatment of TB is by antibiotics such as isoniazid, rifampicin, pyrazinamide and ethumbutol for the first two months and only rifampicin And isoniazid for the last four months. If resistance to isoniazid is high, ethumbutol may be added for the last four months.

The necessity of multiple drugs in treating TB is driven by several factors concerning the causative organism M. Tuberculosis, the propensity of the M. Tuberculosis to persist face of drug treatment and / or attack by the host immune system the tendency of developing resistance to drug therapy.

The compliance to medication therapy for anti-TB is high. Transportation cost for the patients could be reduced by bringing the service close to where they live.

TB grows and develops very slowly, so there is no immediate risk to roommates. Roommates should undergo a montoux TB skin test. If infected, treatment is recommended to prevent the latent infection from developing into active TB.