Free NCLEX Practice Questions.
Take Practice Question # 408
Nclex free Practice Questions.
TUBERCULOSIS
Description
- Highly communicable disease caused by Mycobacterium tuberculosis
- Transmitted by the airborne route
- Multidrug-resistant strains of tuberculosis can result from improper compliance, noncompliance with treatment programs, or development of mutations in tubercle bacillus.
Transmission
- Transplacental transmission is rare.
- Transmission can occur during birth through aspiration of infected amniotic fluid.
- The newborn can become infected from contact with infected individuals.
Risk to mother:
Active disease during pregnancy has been associated with an increase in hypertensive disorders of pregnancy.
Diagnosis:
If a chest radiograph is required for the mother, it is done only after 20 weeks of gestation, and a lead shield for the abdomen is required. Tuberculin skin testing is safe during pregnancy; however the health care provider may want to delay testing until after delivery.
Assessment
Mother
- Possibly asymptomatic
- Fever and chills
- Night sweats
- Weight loss
- Fatigue
- Cough with hemoptysis or green or yellow sputum
- Dyspnea
- Pleural pain
Neonate
- Fever
- Lethargy
- Poor feeding
- Failure to thrive
- Respiratory distress
- Hepatosplenomegaly
- Meningitis
- Disease may spread to all major organs
Interventions
Pregnant client
- Administration of isoniazid (INH), pyrazinamide, and rifampin (Rifadin) daily for 9months (as prescribed); ethambutol (Myambutol) is added if medication resistance is likely.
- Pyridoxine (vitamin B6) should be administered with INHto the pregnant client to prevent fetal neurotoxicity caused by the INH.
- Promote breast-feeding only if the client is noninfectious.
Newborn
- Management focuses on preventing disease and treating early infection.
- Skin testing is performed on the infant at birth, and the infant may be placed on INH therapy; the skin test is repeated in 3 to 4 months, and INH may be stopped if the skin test results remain negative.
- If the skin test result is positive, the infant should receive INH for at least 6 months (as prescribed).
- If the mother’s sputum is free of organisms, the infant does not need to be isolated from the mother while in the hospital.
