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In: Nursing

Wilson is a 36-year-old migrant worker. He was admitted to the Hospital with a cough, unintended...

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?

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?
  • Cite all references

Solutions

Expert Solution

Answer to Question No.1

Tuberculosis is an infectious disease caused by bacteria that mainly affects the lungs. The bacteria spread from one person to another through the air via coughs or sneezes.

The TB bacteria in the body can be detected by the following diagnostic tests:

  • TB skin test (TST): A small amount of PPD tuberculin is injected just below the skin of the inside of the forearm. The injected site is examined after 2 days for a hard and swollen area, which indicates the risk of infection by the bacteria.
  • TB Blood test: T-SPOT – TB test and Quantiferon TB Gold-in Tube test are done to determine the presence of TB bacteria in the blood.
  • Chest X-ray: A chest X-ray helps in determining the spots in the lungs and or changes in the lungs caused by TB bacteria.
  • Sputum test: This test is used to determine drug-resistant strains of TB.

Answer to Question No.2:

Isolation precautions help in lowering and preventing the spread of infections. Tuberculosis is an air-borne disease. Such patients should be isolated and in separate negative pressure rooms.

  • There must be a limited number of staff and visitors entering the room.
  • Care providers and other members visiting the room should use a respirator mask and face shield before entering the room.
  • Wear gloves and gowns before touching the infected person.
  • Do not allow the patients to leave the room unnecessarily. Restrict their movement within the hospital.
  • Educate the patient on cough etiquette. Cover the mouth and nose while coughing or sneezing.
  • Instruct the patient to wear a mask when stepping out.

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