OM VERMA ASSISTANT PROFESSOR GRACIOUS COLLEGE OF NURSING ABHANPUR (C.G.)

1. SEMINAR ON
PULMONARY
TUBERCLOSIS

3. INTRODUCTION

INTRODUCTION

4. The primary infection
agent,mycobecterium
tuberculosis is an acid fast
aerobic rob that grows
slowly and is sensitive to
heat and ultraviolet light

5. DEFINITION
 ACCORDINGTO “ LEVIS COLLIER”
 “tuberculosis is the bacterial
infectious disease transmitted by
mycobacterium tuberculosis”.
 ACCORDINGTO “ LIPPINCOTT”
 “ tuberculosis is a highly infectious
disease ,which is caused by mycobacterium
tuberculin and it is an acid fast aerobic rod that
grow slowly and it is sensitive to heat and
ultraviolet (uv) light ’’.

7. Etiology
 AGENT- Causative organism(mycobacterium
tuberculie)
 Airborn infection(talking,coughing,singing)
 Droplet infection(sneezing,talking.laughing)
HOST FACTORS-
AGE
NUTRITION
IMMUNITY - Low immunity person

9. OTHER
 Before pulmonary infection
 Family history
 Genetic factor
 Smoking
 Pollution
 Secondary infection
 Passive smoker
 Person living in over crowed area

10. PATHOPHYSIOLOGY
 Due to etiological factor
 Microorganism enter the body by
airborne/droplet infection
 Inflammation occur
 The bacteria are transmitted through the airway
to the alveoli.
 Where they are deposited and multiply.
 The bacteria are also transmitted via the lymph
system and bloodstream to the other part of the
body
 The body immune system respond by initiating an
inflammatory reaction.

11.  Phagocytosis process occur ( neutrophils and
macrophages engoulph many of bacteria )
 Specific lymphocytes lyses the bacilli and
normal tissue
 This tissue reaction result in the accumulation
of exudates in the alveoli
New tissue masses called granulomas.

12.  granulomas. new tissue masses of live and dead
bacilli are surrounding by microphages
 granulomas. Are the transformed to a fibrous
mass
 Tissue necrotic
 The lead to excessive mucus production and
breathing difficulty
 The lead to pulmonary tuberclosis

16. CLINICAL FEATURES
 CLINICAL MANIFESTATION:-
 Cough(mucopurulent)
 Dyspnea
 Fever (low grade fever)
 Infection
 Chest pain
 Fatigue
 Malaise
 Anorexia
 Weightloss
 Nightsweating
 Hemoptysis

 .

19. DIAGNOSTIC EVALUATION
 DIAGNOSTIC FINDINGS:-
 The diagnosis ofTB is made by a complete
history,physical examination,chest x-ray,acid fast
bacillus smer,sputum culture,and tuberculin skin
test.
 the chest x-ray usauallay will reveal leision in the
upper lobes.

20.  ,ACID FAST BACILLUS SMER,SPUTUM
CULTURE
 An early morning sputum for an afb culture is
obtained.the afb smear indicate the
wheather mycobacterium is present
,indivating the diagnosis of tuberculosis
 AFB smear—a microscopic examination of a
person's sputum or other specimen that is
stained to detect acid-fast bacteria. It is a
rapid test used to provide results within one
to two days. It is valuable in helping to make
decisions about treatment while waiting for
culture results

21.  TUBERCULIN SKINTEST:-
 the mantoux test is a skin test that is used to
determine if a person has been infected with theTB
bacilli.tubercle bacilli extract is injected into the
intradermal layer of the inner aspect of the
forearm,approximately 4 inches below the
elbow.intermediate strength of purified protein
derivative is used.using a ½ inches 26-27 needle is
inserted beneath the skin with the bavel of needle
up.then 0.1 ml ppd is injected ,created an elevation
in the skin ,the test is read 48-72 hrs after
injection.the tuberculin skin test is a delay localized
reaction which indicate the person is sensitive to
tuberculin.

22. MEDICAL MANAGEMENT
 Pulmonary tuberculosos is treated ith chemotherapeutic agent
for a period of 6-12 month.five first line medication are used.

 Resistance of m.tuberculosis to medication continues to be a
growing issue worldwide.the incidence of multidrug resistance
has created a new challange .several types of drug must be
considered when planning effective therapy.
 Primary drug resistance is resistance to one of the first line
antituberculosis agent in a person who has not had previous
treatment.
 Secondary drug resistance is resistance to one or more
antituberculosis agent in the patient under going therapy.
 Multidrug resistance is resistance to a two agents,namely inh,rif.

25. compression of the heart by an accumulation
of fluid in the pericardial sac.
( compression of the heart by
an accumulation of fluid in the
pericardial sac cardiac
tamponade)

27.  NURSING PROCESS:-
 ASSESSMENT
 A complete history and physical examination are
performed ,clinical manifestation of fever
,anorexia,weight loss,night sweats,fatigue,cough
and sputum production prompt a more thorough
assessment of respiratory function.

28.  NURSING DIAGNOSIS
 Ineffective airway clearance releted copius
tracheobronchial secretion.
 Activity intolerance releted to fatigue .
 Self care deficit releted to chest pain
 Anxity releted to blood in cough

29.  GOAL
 Maintenance of a patent airway .
 Increased activity tolerance.
 To improve the self care.
 To increase the confidence level.

30.  PLANNING
 Maintenance of a patent airway.
 To give the comfortable position .
 Increasing fluid intake.
 To give advice to wear humidity face mask or a humidifier.
 Increased activity tolerance.
 Working schedule is planned.
 A nutrional plan that allows for small frequent meals may be required.
 Liquid nutrional suppliments with high caloric requirement.
 To improve the self care.
 To increase the confedence level.
 To give the proper nutrition.
 To encourage the patient to do itself.
 To increase the confidence level
 To give the psychological support.
 To encourage the patient to communicate to others.
 To encourage the patient that he can do it.

31. OUTCOME
 EXPECTED OUTCOMES
 He will be free from difficulty in breathing.
 IT will be a sense of well being.
 He will be communicate to others.
 He will be do it.

32.  Health education
 To advice the patient to give frequent diet.
 To give the knowledge of common side effect.
 Give the knowledge regarding disease and its
treatment.
 Give health talk about diet and infection control.
 Give health about the preventive measures.
 To reassurance the patient.
 To give all the knowledge regarding medication
and itd doses.

33.  CONCLUSION
 pulmonary tuberculosis is one of the too most
prominent microbacterium diseases known to human
kind the other is leprosy.it is the bacterial infection
disease transmitted by microbacterium tuberculie.it
usually involve the lungs ,but it also occur in the
kidney ,bones,lymph nodes and meninges and can be
disseminated through out the body.
 The centre for disease control and prevention reports
an estimated 2 billion people or one third of the world
population are infected with the bacterium that cause
tuberculosis.the organism causingTB,is an extremely
opportunistic pathogens