Pneumonia Q 36

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The nurse is teaching a client who has been diagnosed with TB how to avoid spreading the disease to family members. Which statement(s) by the client indicate(s) that he has understood the nurse’s instructions? Select all that apply.

  

     A. “I will need to dispose of my old clothing when I return home.”

     B. “I should always cover my mouth and nose when sneezing.”

     C. “It is important that I isolate myself from family when possible.”

     D. “I should use paper tissues to cough in and dispose of them properly.”

     E. “I can use regular plates and utensils whenever I eat.”

    

Correct Answer: B, C, D, E

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Review pathology of disease (active and inactive phases; dissemination of infection through bronchi to adjacent tissues or via bloodstream and/or lymphatic system) and potential spread of infection via airborne droplet during coughing, sneezing, spitting, talking, laughing, singing.

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Option A: Identify others at risk like household members, close associates, and friends. Those exposed may require a course of drug therapy to prevent spread or development of infection.

Option B: Instruct patient to cough or sneeze and expectorate into tissue and to refrain from spitting. Initial therapy of uncomplicated pulmonary disease usually includes four drugs, e.g., four primary drugs or combination of primary and secondary drugs.

Option C: Review necessity of infection control measures. Put in temporary respiratory isolation if indicated. May help the patient understand the need for protecting others while acknowledging the patient’s sense of isolation and social stigma associated with communicable diseases.

Option D: Review proper disposal of tissue and good hand washing techniques. Encourage return demonstration. Compliance with multidrug regimens for prolonged periods is difficult, so directly observed therapy (DOT) should be considered.

Option E: Contagious period may last only 2–3 days after initiation of chemotherapy, but in presence of cavitation or moderately advanced disease, risk of spread of infection may continue up to 3 months.

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