TB in Elderly Man: Boris Vasilescu's Case Study - Essay Sample

Introduction

Tuberculosis is a respiratory infection that can be acute or chronic. Scientifically. It caused by Mycobacterium tuberculosis (Gurjav et al. 2018). The patient under the study is Boris Vasilescu and is 62 years old. Boris gets to display signs and symptoms that are very much relatable to one having tuberculosis. Boris shows a persistent cough that gets to be ongoing for about five months and counting. The person also gets to sweat a lot at night, experiences cases of getting worn out at most times. Recently, he has had a cough that gets accompanied with stains of blood. The wife at home indicated that her husband seems to have lost appetite. The reason behind this is that he has not been eating the food she cooks at home.

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The diagnosis at the hospital indicated that Boris displayed more physical symptoms like chest pains, clumsy skin, abnormal temperatures, and many other signs and symptoms (Outhred et al, 2016). All the symptoms mentioned above can simply assist in the detection of tuberculosis among the patients who display them in hospitals and even homes. Some may have different signs and symptoms (Tebruegge et al. 2016), but the above listed showed by Boris are the most common when one gets infected with tuberculosis in their body. When the diagnosis is done, receives carried out, the results will most likely show that there is tuberculosis in the body.

Pathophysiological Changes Associated with Tuberculosis.In most cases of people having tuberculosis, the nature of their pathological changes will always depend on the exposure of the patients to diseases or the nature of the disease (Mason et al. 2016). For Boris, it indicates that it is 's the nature of tuberculosis that has determined the type of changes in his body. The pathological changes take place in the patient's body, with the signs affecting the usual psychological processes of the given patient most of the time. The primary causes of tuberculosis usually affect the children where the granulomatous lymph gets infected (Nieto et al, 2016). If the case receives treated early enough, it will completely disappear from the body, but if not, it can cause fatalities.

In many cases of post-primary tuberculosis, its majorly made up of examples of active tuberculosis. The cases in this part can easily get transmitted from an infected person to a healthy person (Genedovskaya et al. 2016). The transmission can take place through aerosol sprays. Post-primary infections like that of Boris may happen as a result of having infected with tuberculosis. In this case. The inflammation of the granulomas in the lungs spreads widely compared to primary tuberculosis. The upper parts of the lungs get affected, and the effect of cavitation can take place. Boris had post-primary tuberculosis affecting her lungs. He displayed various signs and symptoms in his own body, which prompted the hospital to put him under proper medication to ensure that he recovers quite well. The changes that got visible in his body were like the rise in the body temperature, sharp chest pain, shortness in his breath, and many others indicating that his upper parts of the lungs were getting infected with the tuberculosis bacterium, and he needed medication.

With tuberculosis affecting the patients through inflammation of some parts of the lungs, it requires one to get proper medication. Boris gets given the appropriate remedy to handle the changes in his body, but still, his wife reports that he does not take the medication that he got given while at the hospital. Without taking the medications, the pathological changes that will occur in the patient's body will increase by a high margin, which can prompt further infections of the type of tuberculosis the person ha in the body.

The lack of proper medical care of the patient brings about further inflammation if the patient's body at all times. It will increase the number of chances of spreading the infection from one person to another most of the time (Dirlikov et al. 2015). Lack of proper medication and drug administration to the person being affected with tuberculosis causes the patient to develop more resistant tuberculosis strains in their bodies. With this, it will be quite tough to manage them since they also come with more robust pathological signs and symptoms in the human body.

Pharmacological Management Prescribed for the Patient.The patient Boris, got issued with the relevant prescription of the drugs that would suppress the inflammation in the upper part of the lungs. In this part, the patient and the medical practitioner have to make sure that they make use of them (Alene et al, 2019). The drugs that get discussed are the ones that treat Boris's tuberculosis condition in his body.

The drugs are generally given to the patient once he gets to be proved by the hospital to be fully susceptible to the infection of tuberculosis. For Boris's case, at the hospital the hospital he was admittedhospitalized for a month before being released to go home under proper medication. Later on, he does not follow the hospital's requirements, which is to take the drugs at the right time with the correct dosage without missing them.

Various pharmacological management procedures must get followed on a regular event of diagnosis of the patient with tuberculosis infection. The hospital where Boris got admitted has not mentioned whether he was isolated, but the admission was a good idea. Usually, this allows for proper monitoring of the patient while preventing further spread of the bacterium from one person to a healthy person. The medical practitioners must, at the same put on the necessary personal protective equipment to protect them from contracting the bacterium. From there, the health practitioners monitor the condition of the given patient so that they can get the correct prescriptions. Even before they began treatment upon Boris' health condition, the first step they took before administering the drugs was the diagnosis. The purpose of the diagnosis is to see the patient's level of infection and see how far he can get assisted.

The drug therapy is also a vital step that the health practitioner carried out before administering them to the patient (Tacconelli et al. 2016). It happens before the dosage gets given during admission and before the patient is released to go home. The first treatment of tuberculosis involves patients getting started on a 4-drug regimen. The drugs used are isoniazid, rifampin, and pyrazinamide. The last one is either using streptomycin or ethambutol (Siripassorn et al. 2018). These drugs are quite crucial in the reduction of the effects of inflammation. The drugs also reduce signs and symptoms that are in the body of the patient.

If the patient has tuberculosis, the fourth drug used is either ethambutol or streptomycin, gets eliminated from the prescribed drugs (Reid et al. 2016). Once the patient is susceptible, the patient should strive to ensure that the medication is taken on time with the right dosage to ensure the effectiveness of the dosage upon the body. For the case of Boris, in the initial treatment of the signs and symptoms, various relevant drugs got used in the whole event to suppress the signs and symptoms. He was not given all the required medications before the early diagnosis before being fully confirmed to have tuberculosis.

Nursing Diagnoses Relevant to Tuberculosis mManagement.The proper nursing care plan for every patient ensures that the patient gets the appropriate care at all times in the journey of recovery. The nursing care plan's significant steps are looking at the infection risk, ineffective airway clearance, and impaired gas exchange that is risky, risky kind of nutrition, and having insufficient knowledge (Mason et al. 2016). All of them will assist the nursing in ensuring that the patient gets faster healing form the tuberculosis infection in their bodies.

The nurses ensured that theyfirst care plan is looked ing at the risk of infection. Here, the nurses put their focus on looking at the increased chance of the patient getting invaded by pathogens. The nurses carried the steps out well for the patient Boris before his release. The procedure for infection risk management is to reduce the spread of the bacterium to other healthy people. It also prevents further reactivation of tuberculosis.

The nurses also ensured there was second nursing care plan is to ensure proper airway clearance in the body of the patient. Since the bacterium affects the respiratory system and majorly lungs, the nursing plan provides that the airway is in good shape (Gurjav et al. 2016). For patients like Boris during that one month, the step was done carried out to ensure recovery.

The routine of third care plan that the nurses give to the tuberculosis patient is to ensuringe the risk of poor nutrition gets reduced is also a nursing care plan. For any patient to fight disease infections, the body must have the proper nutrition to ensure that the patient receives adequate healing. This care plan works for patients like Boris to ensure that the immune system is quite good. The plan's diagnosis is to observe if the nutrition is not balanced and less than the body's requirements (Dale et al, 2017). The diagnosis is done by looking at the bodyweight, patient regular diet plan, and monitormonitoring theof the weight periodically.

The fourth care plan is about looking at the impaired gas exchange of the patient. The risk of getting monitored is the cases for excess or reduced oxygenation and carbon (iv) oxide elimination from the body (Outhred et al, 2016). The diagnoses that can get done are checking for the breathing sounds, change in the mentation levels in the body, and ensuring that the patient's pulse oximetry gets well monitored.

Relevant Education Topics

Before Boris or any other tuberculosis patient gets released from the hospital, one undergoes relevant topics to ensure they complete their journey of recovery quite well. It is's the basic knowledge that the nurses give to the patient about their health condition and how to ensure that they follow the procedures quite well. The first thing is about the misinterpretation of their health status (Pathak et al. 2016). The nurses will then explain to the patient about the causes of tuberculosis, signs, and symptoms, and prevention. The signs and symptoms of tuberculosis that would require reintervention get described to the patient. A plan of how the patient can get proper follow-up care should also get told to the patients before release. The measures of how to take the drugs efficiently and time get explained (Kamarulzaman et al. 2016). Lastly, Boris and other tuberculosis patients before release get given a proper nutrition plan that they can follow to ensure that they recover quite well.

References

Alene, K. A., Viney, K., McBryde, E. S., et al. (2019). Risk factors for multidrugresistant tuberculosis in northwest Ethiopia: A case–control study. Transboundary and Emerging Diseases, Volume 66. Issue 4. Retrieved from https://doi.org/10.1111/tbed.13188

Dale, K.D., Tay, E.L., Trauer, J.M. et al. (2016). Comparing tuberculosis management under public and private healthcare providers: Victoria, Australia, 2002–2015. BMC Infect Dis 17, 324. Retrieved from https://doi.org/10.1186/s12879-017-2421-x

Dirlikov, E., Raviglione, M., & Scano, F. et al. (2015). Global Tuberculosis control: toward the 2015 targets and beyond. Annals of Internal Medicine. Retrieved from https://doi.org/10.7326/

M14-2210 Global Tuberculosis Control: Toward the 2015 Targets and Beyond. Annals of Internal Medicine. https://doi.org/10.7326/M14-2210

Genedovskaya, E. V., et al. (2016). Global, regional, and national burden of Alzheimer's disease and other dementias, 1990–2016: a systematic analysis for the G...