6.12 Learning Activities

Tuberculosis Case Study (Case Study answers are located in the Answer Key.)

Mrs. Xiong is a 38-year-old woman who presents with a three-week history of fatigue, night sweats, anorexia, weight loss, and a persistent dry cough. She was admitted to the hospital for further evaluation. Mrs. Xiong’s chest X-ray shows cavitary lesions in her right upper lung lobe. She is diagnosed with pulmonary tuberculosis (TB) based on her clinical presentation and imaging findings. The following is an account of her hospital stay, including nursing assessments, interventions, and education.

Upon admission, Mrs. Xiong appears fatigued and malnourished. She has a body temperature of 101°F, pulse 100 bpm, and respirations 24 breaths per minute. Her blood pressure is 120/80 mmHg. Her chest examination reveals reduced breath sounds in the right upper lobe and occasional crackles. She has no apparent respiratory distress. Her skin is warm and dry with no evidence of cyanosis or clubbing. Laboratory tests show an elevated white blood cell count and a positive sputum acid-fast bacilli (AFB) test.

1. What are the key findings in Mrs. Xiong’s physical examination that suggest a diagnosis of pulmonary tuberculosis (TB)?
2. What is the first-line therapy for treating active pulmonary TB, and what are the possible side effects of these medications?
3. What nursing interventions are essential to prevent the spread of TB infection in the hospital setting and ensure Mrs. Xiong’s safety and well-being?
4. What should Mrs. Xiong be educated about regarding her condition, including the importance of medication adherence, infection control measures, and follow-up care?