A community health nurse is conducting an educational session with community members regarding TB. The nurse tells the group that one of the first symptoms associated with TB is:
A. A bloody, productive cough
B. A cough with the expectoration of mucoid sputum
C. Chest pain
D. Dyspnea
Correct Answer: B. A cough with the expectoration of mucoid sputum
One of the first pulmonary symptoms includes a slight cough with the expectoration of mucoid sputum. A chronic cough, hemoptysis, weight loss, low-grade fever, and night sweats are some of the most common physical findings in pulmonary tuberculosis. Other options are late symptoms and signify cavitation and extensive lung involvement.
Option A: As the bacterium begins multiplying in the body and destroying tissue, it causes symptoms such as a bad, persistent cough, fatigue/loss of energy, weight loss, loss of appetite, chills, fever, drenching night sweats, chest pain, and coughing up or spitting up bright red blood, a symptom that occurs when the blood vessels inside the lungs become eroded and begin to bleed.
Option C: Pulmonary or systemic dissemination of the tubercles may be seen in active disease, and this may manifest as miliary tuberculosis characterized by millet-shaped lesions on chest x-ray. Disseminated tuberculosis may also be seen in the spine, the central nervous system, or the bowel.
Option D: Secondary tuberculosis differs in clinical presentation from the primary progressive disease. In secondary disease, the tissue reaction and hypersensitivity is more severe, and patients usually form cavities in the upper portion of the lungs.
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