5 Pulmonary Tuberculosis Nursing Care Plans

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Tuberculosis is an acute or chronic infection caused by Mycobacterium tuberculosis. TB is characterized by pulmonary infiltrates, formation of granulomas with caseation, fibrosis, and cavitation. People living in crowded and poorly ventilated conditions and who are immunocompromised are most likely to become infected. In the United States, incidence is higher among the homeless, drug-addicted, and impoverished populations, as well as among immigrants from or visitors to countries in which TB is endemic. In addition, persons at highest risk include those who may have been exposed to the bacillus in the past and those who are debilitated or have lowered immunity because of chronic conditions such as AIDS, cancer, advanced age, and malnutrition. When the immune system weakens, dormant TB organisms can reactivate and multiply.

When this latent infection develops into active disease, it is known as reactivation TB, which is often drug resistant. Multidrug-resistant tuberculosis (MDR-TB) is also on the rise, especially in large cities, in those previously treated with antitubercular drugs, or in those who failed to follow or complete a drug regimen. It can progress from diagnosis to death in as little as 4–6 weeks. MDR tuberculosis can be primary or secondary. Primary is caused by person-to-person transmission of a drug-resistant organism; secondary is usually the result of nonadherence to therapy or inappropriate treatment.

Nursing Care Plans

Here are five (5) nursing care plans (NCP) and nursing diagnosis (NDx) for pulmonary tuberculosis:

  1. Risk for Infection
  2. Ineffective Airway Clearance
  3. Risk for Impaired Gas Exchange
  4. Imbalanced Nutrition: Less Than Body Requirements
  5. Deficient Knowledge
  6. Other Possible Nursing Care Plans
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Imbalanced Nutrition: Less Than Body Requirements

Nursing Diagnosis

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  • Nutrition: imbalanced, less than body requirements

May be related to

  • Fatigue
  • Frequent cough/sputum production; dyspnea
  • Anorexia
  • Insufficient financial resources

Possibly evidenced by

  • Weight 10%–20% below ideal for frame and height
  • Reported lack of interest in food, altered taste sensation
  • Poor muscle tone

Desired Outcomes

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  • Demonstrate progressive weight gain toward goal with normalization of laboratory values and be free of signs of malnutrition.
  • Initiate behaviors/lifestyle changes to regain and/or to maintain appropriate weight.
Nursing InterventionsRationale
Document patient’s nutritional status on admission, noting skin turgor, current weight and degree of weight loss, integrity of oral mucosa, ability or inability to swallow, presence of bowel tones, history of nausea and vomiting or diarrhea.Useful in defining degree or extent of problem and appropriate choice of interventions.
Ascertain patient’s usual dietary pattern. Include in selection of food.Helpful in identifying specific needs and strengths. Consideration of individual preferences may improve dietary intake.
Monitor I&O and weight periodically.Useful in measuring effectiveness of nutritional and fluid support.
Investigate anorexia and nausea and vomiting, and note possible correlation to medications. Monitor frequency, volume, consistency of stools.May affect dietary choices and identify areas for problem solving to enhance intake and utilization of nutrients.
Encourage and provide for frequent rest periods.Helps conserve energy, especially when metabolic requirements are increased by fever.
Provide oral care before and after respiratory treatments.Reduces bad taste left from sputum or medications used for respiratory treatments that can stimulate the vomiting center.
Encourage small, frequent meals with foods high in protein and carbohydrates.Maximizes nutrient intake without undue fatigue/energy expenditure from eating large meals, and reduces gastric irritation.
Encourage SO to bring foods from home and to share meals with patient unless contraindicated.Creates a more normal social environment during mealtime, and helps meet personal, cultural preferences.
Refer to dietitian for adjustments in dietary composition.Provides assistance in planning a diet with nutrients adequate to meet patient’s metabolic requirements, dietary preferences, and financial resources post discharge.
Consult with respiratory therapy to schedule treatments 1–2 hr before or after meals.May help reduce the incidence of nausea and vomiting associated with medications or the effects of respiratory treatments on a full stomach.
Monitor laboratory studies: BUN, serum protein, and prealbumin, albumin.Low values reflect malnutrition and indicate need for intervention and change in therapeutic regimen.
Administer antipyretics as appropriate.Fever increases metabolic needs and therefore calorie consumption.
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Recommended Resources

Recommended nursing diagnosis and nursing care plan books and resources.

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See Also

Other recommended site resources for this nursing care plan:

Other nursing care plans related to respiratory system disorders:

Matt Vera is a registered nurse with a bachelor of science in nursing since 2009 and is currently working as a full-time writer and editor for Nurseslabs. During his time as a student, he knows how frustrating it is to cram on difficult nursing topics. Finding help online is nearly impossible. His situation drove his passion for helping student nurses by creating content and lectures that are easy to digest. Knowing how valuable nurses are in delivering quality healthcare but limited in number, he wants to educate and inspire nursing students. As a nurse educator since 2010, his goal in Nurseslabs is to simplify the learning process, break down complicated topics, help motivate learners, and look for unique ways of assisting students in mastering core nursing concepts effectively.
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