Tuberculosis Practice Questions with Answers and NCLEX® Review

Introduction to Tuberculosis

Mycobacterium is an acid-fast, aerobic, slow-growing bacillus that is resistant to drying and many disinfectants. However, the microbes can survive in dried sputum for weeks.

The TB bacterium is spread from person to person through droplets from coughing or sneezing. People who live with or spend time with an infected person may be at risk for developing TB. The bacteria then travel from the lungs through the bloodstream to other organs, where they can cause damage over time if not appropriately treated with antibiotics.

There are two stages of tuberculosis: primary and secondary (or reinfection). Primary occurs when the microorganisms first enter the lungs. The TB may spread to other organs with the bacilli migrating to lymph nodes, which can rapidly disseminate into the circulation and to other tissues, such as bone or kidney. 

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Secondary (reinfection) can occur years after the primary infection when the bacilli are reactivated due to the host’s decreased resistance.

Infection usually begins with symptoms similar to those of a cold, such as chest pain and fatigue. TB can be deadly if left untreated and can affect any organ in the body, including the brain and kidneys. The most common symptom is a cough that lasts more than three weeks. Other symptoms include night sweats, fatigue (feeling very tired), chills, and weight loss.

Tuberculosis Pathophysiology

The tubercle bacilli are spread through sneezing and coughing and carried in droplets small enough to reach the alveolar spaces. If the host’s defense system does not eliminate the infection, the bacilli will grow and eventually kill cells. 

These infected macrophages produce chemicals that attract other phagocytic cells, which eventually form a granuloma on the tubercle. This enlarges the bacilli for entering nearby lymph nodes. This creates lymphadenopathy, which is a clinical manifestation of primary tuberculosis. 

If the host fails to respond, this will continue to grow and expand into the lungs and lymph nodes, creating infection and necrosis. This is the beginning of tuberculosis (TB). The lung can no longer function properly. If Tuberculosis is not treated, it becomes fatal.

Tuberculosis can lie dormant for years or decades before causing active TB disease, which occurs when an immune system weakened by another illness, such as AIDS or diabetes, is unable to fight off the infection. This is known as latent TB.

In active TB, the client remains contagious until they are treated with medications prescribed by a health care provider (HCP).

Memory Trick

• Terrible cough “blood tinged”
• Bad infection: fever, night sweats, weight loss

Tuberculosis Signs and Symptoms

• Night Sweats
• Weight loss
• Dyspnea & SOB
• Fever & chills
• Cough + Hemoptysis “Blood tinged sputum”

Tuberculosis Drugs

Rifampicin – This medication works by blocking an enzyme called RNA polymerase that helps make new bacteria in the body. It also helps relieve symptoms like coughing and fever.

Ethambutol – This medication helps stop the growth of Mycobacterium tuberculosis bacteria in the body. It can also make it easier for other medicines to work better because it blocks an enzyme called tuberculin-b antigen pyruvate kinase (TbAPK). It also helps reduce sputum production (phlegm), which makes it easier to cough up mucus through the mouth or nose instead of the throat so it doesn’t go back into the lungs where it could cause infection or damage them further.

Streptomycin – This medication works by killing mycobacterium tuberculosis bacteria before they can multiply enough to cause serious damage inside the lungs or elsewhere throughout the body.

Nursing Interventions for Tuberculosis

Administer pain relief drugs (such as acetaminophen, ibuprofen, or opioids) as prescribed.

Monitor vital signs frequently (heart rate and respiratory rate) and report any fluctuations to the HCP immediately.

Assess intake and output, including weight gain or loss, to ensure adequate hydration.

Encourage clients to wear masks in public places and at home.

Conclusion to Tuberculosis

Tuberculosis (TB) is spread by a sneeze or cough. People who live with or spend time with an infected person are at risk of developing TB. The bacteria can travel from the lungs to the heart, brain, and other organs, where they can cause damage over time if not appropriately treated with antibiotics.

TB can be deadly if left untreated, and can attack other organs in the body, including the brain and kidneys. The most common symptom is a cough that lasts more than three weeks. Other symptoms include night sweats, fatigue, chills, and weight loss.

Sources

https://www.merckmanuals.com/professional/infectious-diseases/mycobacteria/tuberculosis-tb 

https://www.mayoclinic.org/diseases-conditions/tuberculosis/symptoms-causes/syc-20351250