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Communicable Disease Nursing

I. EPI DISEASES DISEASE 1. Tuberculosis Other names: Koch’s Disease Consumption Phthisis Weak lungs CAUSATIVE AGENT Mycobacterium tuberculosis TB bacillus Koch’s bacillus Mycobacterium bovis (rod-shaped) MODE OF TRANSMISSION Airborne-droplet Direct invasion through mucous membranes and breaks in the skin (very rare) PATHOGNOMONIC SIGN 1. Usually asymptomatic 2. Low-grade afternoon fever 3. Night sweating 4. Loss of appetite 5. Weight loss 6. Easy fatigability – due to increased oxygen demand 7. Temporary amenorrhea 8. Productive dry cough 9. Hemoptysis MANAGEMENT/TREATMENT Diagnostic test: • Sputum examination or the Acid-fast bacilli (AFB) / sputum microscopy 1. Confirmatory test 2. Early morning sputum about 3-5 cc 3. Maintain NPO before collecting sputum 4. Give oral care after the procedure 5. Label and immediately send to laboratory 6. If the time of the collection of the sputum is unknown, discard • Chest X-ray is used to: 1. Determine the clinical activity of TB, whether it is inactive (in control) or active (ongoing) 2. To determine the size of the lesion: a. Minimal – very small b. Moderately advance – lesion is < 4 cm c. Far advance – lesion is > 4 cm • Tuberculin Test – purpose is to determine the history of exposure to tuberculosis Other names: Mantoux Test – used for single screening, result interpreted after 72 hours Tine test – used for mass screening read after 48 hours Interpretation: 0 - 4 mm induration – not significant 5 mm or more – significant in individuals who are considered at risk; positive for patients who are HIV-positive or have HIV risk factors and are of unknown HIV status, those who are close contacts with an active case, and those who have chest x-ray results consistent with tuberculosis. 10 mm or greater – significant in individuals who have normal or mildly impaired immunity PREVENTION • Respiratory precautions • Cover the mouth and nose when sneezing to avoid mode of transmission • Give BCG...