NUR 211 Exam 2 Study Guide – 2025-
2026
Complex Health Concepts (Forsyth Technical Community
College)
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Tuberculosis
What Is TB?
● Highly Communicable Infection Caused By The Mycobacterium Tuberculosis
Organism
● Slow Growing, Acid-Fast Rod Bacteria
● Transmitted Via Aerosolization/Airborne Droplets
● There Is An Active Form And A Latent Form
● Common Secondary Infection In Persons W/ HIV/Aids
Patho
● Mtb Droplet Nuclei
● Implant In Lungs
● Inflammatory Process - Pneumonitis
● Small Lesions (Primary Lesion) Form
0 Lesions Are Surrounded By Collagen,
Fibrin, Lymphocytes… Appear Scar-Like
On CXR
● Latent TB/Active TB
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, 0 Asymptomatic In The Latent Phase… Can Remain Latent (Not Contagious) For
Days, Months, & Years! Can Reactivate Later In Life.
○ Active TB (Symptomatic) = Contagious
Incidence In The US
● Lowest Level Since 1953
● More New Cases In Foreign-Born Individuals
● Risk Higher In Immigrants And Refugees
Risk Factors
● HIV/AIDS/Compromised Immune
System
● Immigrants
● Poverty And Crowded Spaces
● Homeless
● Substance Abusers
● Elderly And Debilitated Patients
● No Access To Medical Care
● Health Care Workers
Millary (Small/Millet Seed) And Extrapulmonary TB
● Progressive, Disseminated.
● Occurs During Primary Dissemination Or After Years Of Untreated Tuberculosis.
● Common In Immunocompromised.
● Can Involve Any Organ
Geriatric Considerations
● Reactivation Of Latent TB By Comorbidities Later In Life Like Diabetes
● Vague Symptoms
● Nursing Home Residents
● Hospitalized
Pediatric Considerations
● Active Disease Can Develop Before (+) PPD Skin Test
Results
● Immature Immune System
● HIV, Malignancies, Or Organ Transplantation At Higher
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● Observe Taking Medications (Medication Compliance)
● Observe S/S For Latent TB
Assessment
● History
0 Signs And/Or Symptoms
○ Exposure To Tuberculosis
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, ○ Living Conditions
○ Birthplace
○ Travel
○ Vaccination History
● Physical Assessment/Clinical Manifestations
0 Progressive Fatigue & Lethargy
○ Unintentional Weight Loss
○ Low-Grade Fever
○ Night Sweats
○ Hemoptysis (Coughing Up Blood)
○ Persistent Cough
○ Crackles/Wheezing
○ Chest Tightness, Ache, Dull Pain
Clinical Manifestations
● Active TB
0 Fatigue, Lethargy
○ Weight Loss, Anorexia
○ Afternoon Low Grade Fever, Chills
○ Cough With Purulent Sputum
○ Night Sweats And General Anxiety
○ Dyspnea, Chest Pain, And Hemoptysis
● Extra Pulmonary TB Disease
0 Common In HIV
○ Symptoms Depend On Organ Affected
■ Neurologic (Confusion & Lethargy)
■ Musculoskeletal (Joint Pain)
■ Urinary
■ Lymphatic (Swollen Lymph Nodes)
■ Respiratory (Chest Pain,
Pleural/Pericardial Rub
& Dyspnea)
Psychosocial Assessment
● The Client Is: Anxious, Afraid Of The Unknown, Isolated, Overwhelmed By
Information
● Assess Their Ability To Learn And Their Support And Resources
● Possible Language Barriers
● Ability To Afford Lengthy Medication Regimen
Diagnostics
● Labs (Not Indicative Of Active)
0 Sputum Analysis (Rapid Results In 2 Hrs… Cultures May Take Up To 4
Weeks To Result)
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, ○ Blood (Quaniferon Gold & TSPOT And Xpert MTB/RIF - Allows The Detection
Of Drug Resistant TB)
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○ Tuberculin Test (PPD “Skin” Test. Most Commonly Used. Induration >=10 Mm (+)
… 5 Mm In Immunocompromised Clients)
● Imaging - CXR After Positive Test Result… Detects Active TB Or Old/Healed Lesions.
Planning And Implementation/Responding
● Promote Airway Clearance
● Decrease Drug Resistance And Infection Spread (Complete
Antx) ○ Combination Drug Therapy With Strict
Adherence
■ Isoniazid
■ Rifampin
■ Pyrazinamide
■ Ethambutol
○ Negative Sputum Culture
● Manage Anxiety
● Improve Nutrition
● Manage Fatigue
Interventions
● Infection Control And Compliance
● Screening Close Contacts (Test All Clients Close Contacts)
● Medication Compliance And Monitoring (Finish Antx To Decrease Risk Of Drug
Resistance)
● Long-Term Therapy
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