Primary Nursing Diagnosis

Risk of infection related to tissue inflammation and infiltration caused by the TB bacilli

OUTCOMES. Immune status; Knowledge: Infection control; Risk control; Risk detection; Treatment behavior: Illness or injury

INTERVENTIONS. Infection control; Medication management; Environmental management; Surveillance; Nutrition management; Teaching: Disease process

U PLANNING AND IMPLEMENTATION Collaborative

Because TB typically becomes resistant to any single-drug therapy, patients generally receive a combination of drugs. The most common combination of drugs prescribed in the United States is INH, rifampin, pyrazinamide, and either ethambutol or streptomycin. Some experts recommend up to 9 months of drug therapy, whereas patients with drug-resistant strains of TB may require as much as 18 months of treatment. Intravenous fluids, total parenteral nutrition, and food supplements may be needed for those with nutritional compromise. Humidity and oxygen are administered to correct hypoxia and to decrease the thickness of secretions. Emergency intubation and mechanical ventilation may be needed in extreme cases.

Teach the patient how and when to take medication and to complete the course of drug therapy because one of the primary reasons for the development of drug-resistant TB strains is the failure of patients to complete medication regimens. If you suspect that the patient may not adhere to the medication regimen, a home health referral is important after the patient is discharged.

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