Question

Community Case: Communicable Disease: Tuberculosis

Case Part 1

Bradley Buchanan presents to the neighborhood nurse-run clinic with shortness of breath, a persistent cough with blood-tinged sputum, recent weight loss, and night sweats. On initial assessment, the client has a fever of 101.4°F and pain in his chest. His other vital signs are as follows: pulse 98 beats per minute; respirations 26 per minute; blood pressure 110/76 mm Hg; height 68 inches; and weight 140 pounds. Mr. Buchanan is 45 years old. He is employed as a dishwasher at a local restaurant and lives at the local shelter with his wife, who is 8 months pregnant, and his 13-year-old son. Mr. Buchanan is concerned that if he cannot go to work, he will lose the family’s only income. At this point, although Mr. Buchanan’s signs and symptoms and his purified protein derivative test results seem to indicate that he may have tuberculosis, the nurse must pursue further confirmation of the diagnosis.

Questions for students:

1. What would be the nurse’s next action?

2. Should the nurse do any testing on the client or his family?

Answer 1

Ans1.The nurse has to decide to treat the patient with a full course of TB treatment.TB is a serious infection,usually of the lungs,caused by the bacteria Mycobacterium tuberculosis.This bacteria spreads when you breathe in the air exhaled by a person infected with TB.A positive test of purified protein derivative skin test indicates the client is infected with TB.

Ans.2 The nurse my advice to do a chest X-ray and a sputum test.If the patient diagnosed with TB he may advised to refrain from work during the initial stages of treatment until clinically better and they are no longer infections.Most patients are no longer infections after approximately two weeks of treatment.He can protect his family members by wearing a mask,cover his mouth and nose with a tissue when he cough,sneeze or laugh.