Pulmonary Tuberculosis - Definition, Etiology, Pathophysiology, Clinical Manifestations, Diagnostic Eexamination, Prevention, Management / Treatment, Assessment and Gordon's Functional Health Patterns
Definition
Tuberculosis is a contagious infectious disease caused by Mycobacterium tuberculosis, an acid-resistant aerobic bacillus transmitted through the air (airborne). In almost all cases of tuberculosis infection acquired through inhalation of small particles of bacteria (approximately 1-5 mm).
Etiology
The cause of pulmonary tuberculosis are germs (bacteria) that can only be seen with a microscope, the mycobacterium tuberculosis. Mycobacterial are aerobic bacteria, shaped stones that form spores.
Pathophysiology
Causes of pulmonary tuberculosis occurs because germs coughed out into droplet nuclei in the air. The infectious particles can settle in free air for 1-2 hours, depending on the presence or absence of ultraviolet light, poor ventilation and moisture. In a humid atmosphere and dark germs can hold for days to months. BCG infection particle is inhaled by healthy people, it will stick to the airway or lungs. Germs will be encountered first by neutrophils, then just by macrophages. Most of these particles will die or cleared by macrophages out of tracheal bronchial branch, along with the movement of cilia in the secretions.
When germs settle in the lung tissue, it will multiply in the cytoplasm of macrophages. Here germs can be brought into other organs. If, entered into the pulmonary artery occurs spreading to all parts of the lungs become miliary tuberculosis.
Of primary nest will arise inflammation hilar lymph channels leading, and also followed by enlarged lymph nodes virus. All this process takes 3-8 weeks.
Clinical Manifestations
Clinical symptoms of tuberculosis can be divided into two groups, namely respiratory symptoms and systemic symptoms.
1. Respiratory symptoms
Diagnostic Examination
Assessment of treatment success was based on the results of bacteriological and clinical examination. Good cure pulmonary tuberculosis will notice sputum smear (-), an improvement of radiology and relieve symptoms.
Complication
Assessment
1. Identity of the patient
Consisting of name, age, gender, religion, and others.
2. Health History
The main complaint: Most cases encountered the client in with complaints of cough more than 3 weeks.
The main complaint history: Usually cough experienced more than 1 week accompanied by an increase in body temperature, decreased appetite and body weakness.
Gordon's Functional Health Patterns
1. Health Perception and Management
View of the patient about the disease and how to deal with patients who carried the disease.
2. Nutritional metabolic
The ability of patients to consume food has decreased due to the lack of appetite / malaise.
3. Elimination
Patients with pulmonary TB is rare impaired bowel and bladder elimination.
4. Activity exercise
Usually, the patient experienced a decrease in activity associated with body weakness experienced.
5. Sleep - rest
Rest and sleep is often disturbed due to cough experienced at night.
6. Cognitive-perceptual
Memory pulmonary TB patients mostly found not impaired.
7. Self perception / self concept
Feelings receive from patients with the situation, most patients are not impaired self-concept.
8. Role Relationship
Changes in the pattern of relations role in responsibilities or changes in physical capacity to perform the role.
9. Se-uality reproductive
The patient's ability to perform in accordance with the gender roles. Most patients do not do se-ual because of the weakness of the body.
10. Coping-stress tolerance
Defense mechanism used by patients is to seek help from others.
11. Value-Belief Pattern
The religion of the patient and patient compliance in performing religious teachings usually not impaired in patients sisitem values and beliefs.
Definition
Tuberculosis is a contagious infectious disease caused by Mycobacterium tuberculosis, an acid-resistant aerobic bacillus transmitted through the air (airborne). In almost all cases of tuberculosis infection acquired through inhalation of small particles of bacteria (approximately 1-5 mm).
Etiology
The cause of pulmonary tuberculosis are germs (bacteria) that can only be seen with a microscope, the mycobacterium tuberculosis. Mycobacterial are aerobic bacteria, shaped stones that form spores.
Pathophysiology
Causes of pulmonary tuberculosis occurs because germs coughed out into droplet nuclei in the air. The infectious particles can settle in free air for 1-2 hours, depending on the presence or absence of ultraviolet light, poor ventilation and moisture. In a humid atmosphere and dark germs can hold for days to months. BCG infection particle is inhaled by healthy people, it will stick to the airway or lungs. Germs will be encountered first by neutrophils, then just by macrophages. Most of these particles will die or cleared by macrophages out of tracheal bronchial branch, along with the movement of cilia in the secretions.
When germs settle in the lung tissue, it will multiply in the cytoplasm of macrophages. Here germs can be brought into other organs. If, entered into the pulmonary artery occurs spreading to all parts of the lungs become miliary tuberculosis.
Of primary nest will arise inflammation hilar lymph channels leading, and also followed by enlarged lymph nodes virus. All this process takes 3-8 weeks.
Clinical Manifestations
Clinical symptoms of tuberculosis can be divided into two groups, namely respiratory symptoms and systemic symptoms.
1. Respiratory symptoms
- Cough for more than 3 weeks.
- Coughing up blood.
- Chest pain.
- Fever.
- Other systemic symptoms: malaise, night sweats, anorexia and weight loss.
Diagnostic Examination
- Sputum culture: positive for mycobacterium tuberculosis.
- Ziehl-Neelsen: positive for acid fast bacilli.
- Skin test (PPD, Mantoux, Pieces volumer) shows: past infection and the presence of anti-bodies, but does not necessarily reflect active disease.
- X-ray of the thorax: early lesions showed infiltration in the lung area above.
- Histology or tissue culture: positive for mycobacterium tuberculosis.
- Examination of lung function: decreased vital capacity, an increase in dead space, increasing the ratio of residual air and total lung capacity, and decreased oxygen saturation secondary to parenchymal infiltration or fibrosis, loss of lung tissue and pleural disease.
Assessment of treatment success was based on the results of bacteriological and clinical examination. Good cure pulmonary tuberculosis will notice sputum smear (-), an improvement of radiology and relieve symptoms.
Complication
- Coughing up blood.
- Pneumothorax.
- Crushed lungs.
- Respiratory failure.
- Heart failure.
- Pleural effusion.
- Can be done by;
- BCG vaccination in infants and children.
- Preventive therapy.
- Diagnosis and treatment of tuberculosis treatment (+) to prevent transmission.
Assessment
1. Identity of the patient
Consisting of name, age, gender, religion, and others.
2. Health History
The main complaint: Most cases encountered the client in with complaints of cough more than 3 weeks.
The main complaint history: Usually cough experienced more than 1 week accompanied by an increase in body temperature, decreased appetite and body weakness.
Gordon's Functional Health Patterns
1. Health Perception and Management
View of the patient about the disease and how to deal with patients who carried the disease.
2. Nutritional metabolic
The ability of patients to consume food has decreased due to the lack of appetite / malaise.
3. Elimination
Patients with pulmonary TB is rare impaired bowel and bladder elimination.
4. Activity exercise
Usually, the patient experienced a decrease in activity associated with body weakness experienced.
5. Sleep - rest
Rest and sleep is often disturbed due to cough experienced at night.
6. Cognitive-perceptual
Memory pulmonary TB patients mostly found not impaired.
7. Self perception / self concept
Feelings receive from patients with the situation, most patients are not impaired self-concept.
8. Role Relationship
Changes in the pattern of relations role in responsibilities or changes in physical capacity to perform the role.
9. Se-uality reproductive
The patient's ability to perform in accordance with the gender roles. Most patients do not do se-ual because of the weakness of the body.
10. Coping-stress tolerance
Defense mechanism used by patients is to seek help from others.
11. Value-Belief Pattern
The religion of the patient and patient compliance in performing religious teachings usually not impaired in patients sisitem values and beliefs.
