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1. TUBERCULOSIS
Presented By:
Banashree Hawaibam
M.Sc Nursing Final Year
Medical-Surgical Nursing
B.V.D.U.C.O.N.Pune.

2. TUBERCULOSIS
 Tuberculosis is an infectious disease that mainly
affects the lung parenchyma.
 It is caused by an infectious
agent,M.tuberculosis,which
is an acid-fast aerobic bacteria.
 It may also be transmitted
to other parts of the body,
including the meninges,
kidneys,bones and lymph nodes.

3. ETIOLOGY AND RISK FACTORS:
1. Inhalation of droplets produced by coughing,
sneezing and splitting.
2. Immunocompromise status.
3. Inadequate health care.
4. Institutionalization.
5. Overcrowded .
6. Immigration.
7. Health care workers.

4. CLASSIFICATION:
 The American Thoracic Society classifies tuberculosis as
follows:
1. Class 0: No exposure; no infection
2. Class 1: Exposure, no evidence of infection.
3. Class 2: Latent infection; no disease.
4. Class 3: Disease; clinically active.
5. Class 4: Disease; not clinically active.
6. Class 5: Suspected disease, diagnosis pending.

5. STAGES OF TUBERCULOSIS:
A. Early infection.
B. Latent period.
C. Secondary tuberculosis.

6. SIGNS AND SYMPTOMS:
1. Fatigue.
2. Loss of appetite.
3. Weight loss.
4. Cough with purulent.
5. Bloody sputum.
6. Fever.

7. DIAGNOSTIC FINDINGS:
1. A complete history and physical examination.
2. Tuberculin skin test.
3. Chest X-ray.
4. Acid fast bacillus smear.
5. Sputum culture.

9. MEDICAL MANAGEMENT:

10.  RNTCP DOTS-PLUS:
1. Multi-Drug resistant-TB suspect.
2. Multi-Drug resistant-TB.

11. POSSIBLE SIDE EFFECTS OF ANTI-TB
DRUGS:
1. Gastrointestinal upset.
2. Itching
3. Burning in hands and feet.
4. Joint pain.
5. Impaired vision.
6. Ringing in the ears.
7. Loss of hearing.
8. Dizziness and loss of balance.
9. Jaundice.

12. SURGICAL MANAGEMENT:
1. Pneumothorax.
2. Thoracoplasty.
3. Removal of a disease lung.

13. NURSING MANAGEMENT:
Impaired gas exchange related to the presence of risk
factors like reduced of surface lung, atelactasis ,thick
secretions, bronchial edema.
Imbalance nutrition less than body requirements
related to frequent coughing, sputum
production,dyspnoea,anorexia.
Knowledge deficit related to disease condition,
treatment regimen and prevention.

14. Risk of infection related to tissue damage due to
spread of infection,malnutrition,lack of knowledge
about infectious germs.
High risk of complications related to the side effects of
medication(hepatitis ,gastrointestinal upset)

15. BIBLIOGRAPHY:
K.Barbara,E Nancy. Introductory Medical-Surgical
Nursing.9th ed.USA.Lippincott Williams and
Wilkins.2007.p.380-3.
Lewis S,Collier L.Medical-Surgical Nursing Assessment
and Management of Clinical
Problems.3rded.USA.Mosby.1992.p.512-7
K Park. Preventive and Social Medicine.20th
ed.India.Banarsidas Bhanot.2009.p.159-74.
Suzanne C,Branda G.Textbook of Medical Surgical
Nursing.10th ed.USA.Lippincott Williams and
Wilkins.2004.p.532-8

16. Linda S,Paula D.Understanding Medical-Surgical
Nursing.USA.F.A.Davis.1999.p.521-5.
TK Indrani.Nursing Manual of Nutrition and Therapeutic
Diet. New Delhi.P.Viz.2003.p.246-9.
http://intl.elsevierhealth.com/journals/tube
www.who.int/mediacentre/factsheets/.../en/
www.who.int/topics/tuberculosis/en/
http://www.lung.org/lung-disease/tuberculosis
www.medindia.net/news/tuberculosis-could-now-be-
diagnosed-with-oral-swab-samples-147104-1.htm

18. Tuberculosis Could Now be Diagnosed With Oral Swab
Samples
by Dr. Trupti Shirole on March 04,2015 at 6:20 AM
Respiratory Disease
News - G J E 4
 Tuberculosis (TB) could now be diagnosed with easy to
obtain oral swab samples, revealed a new study
published in the Scientific Reports.
The preliminary success of the oral swab testing
method offers hope for greatly improved TB detection
and control ,especially in nations with limited public
health resources.

19. New Drugs against Tuberculosis: Problems, Progress,
and Evaluation of Agents in Clinical Development
 Jossy van den Boogaard1,*,
 Gibson S. Kibiki,
 Elton R. Kisanga,
 Martin J. Boeree
 Rob E. Aarnoutse
NEW DRUGS FOR TB TREATMENT
 Fluoroquinolones : The fluoroquinolones are a promising
class of drugs for the treatment of TB . In particular, they
are distributed broadly throughout the body, including
within cells, which explains their efficacy against
intracellular mycobacterium . The fluoroquinolones are
registered as second-line anti-TB drugs

20. Gene mutations in Mycobacterium tuberculosis: Multidrug-resistant:TB
as an emerging global public health crisis
Rahul Mishra,
Priyanka Shukla,
Wei Huang,
Ning Hu
 TB poses formidable challenges to the global health at the public
health and scientific level by acquiring gene mutation into anti TB
drugs specially rifampin and isoniazid which leads resistant to drug
regime and treatment form. most important is global commitment at
all levels to roll back TB before it expose us again.
 Rapid development of drug resistance caused by M. tuberculosis
has lead to measure resistance accurately and easily. This knowledge
will certainly help us to understand how to prevent the occurrence of
drug resistance as well as identifying genes associated with new drug
resistance.

21.  Human B cells produce chemokine CXCL10 in the
presence of Mycobacterium tuberculosis specific T cells.
Soren T. Hoff , Ahmed M. Salman , Morten
Ruhwald,Pernille Ravn , Inger Brock,Nabila Elsheik,
Peter Andersen, Else Marie Agger
7 July 2014 2014
Conclusion: Human B cells are able to produce CXCL10 in
an IFN-g and T cell contact-dependent manner.The
present findings suggest a possible mechanism through
which B cells in part may influencegranuloma,
formation in human tuberculosis (TB) and participate
in infection control

22.  The present and future of tuberculosis vaccinations
By: Nicola Principi, Susanna Esposito.
18 August 2014
 Conclusions:Until a new vaccine has been proven to
be more effective and safe than the BCG vaccine, the
BCG vaccine should be maintained in immunization
schedules for neonates and children at risk as a
fundamental prophylactic measure.

23. THANK YOU