Nursing care of Tuberculosis Pleuritis Patients : Case Study

Abstract

Abstract

            Introduction : Tuberculosis (TB) is a communicable disease and a major public health issue, particularly among prison inmates, who are at high risk for both tuberculosis and drug-resistant TB. Due to the overcrowded conditions in prisons, TB can spread easily within these environments.

            Objective : This case study aims to study the nursing care of a patient with tuberculous pleuritis at Sikhio Hospital, Nakhon Ratchasima Province.

            Methodology : The study focuses on the nursing care of a single patient with tuberculous pleuritis at Sikhio Hospital. Data were collected from the patient's medical records, interviews, expert consultations, and the tuberculosis network within the prison system. The nursing process was used to identify nursing diagnoses based on Gordon’s Functional Health Patterns.

            Results : The patient was a 42-year-old Thai male inmate with a history of regular smoking and alcohol consumption. Chief complaint were high fever and dyspnea one day prior. Sputum examination did not detect tuberculosis bacteria, but pleural fluid analysis showed lactate dehydrogenase (LDH) at 313 IU/L and adenosine deaminase (ADA) at 42 IU/L, leading to a diagnosis of tuberculous pleuritis. He received a full course of antibiotic treatment. Health assessment identified several nursing problems: Risk of oxygen deficiency, Risk of tuberculosis transmission, Fever due to pulmonary infection, Electrolyte imbalance, Risk of side effects from anti-tuberculosis medications, Inappropriate coping pattern with stress, Irritability and mood swings and Lack of knowledge about tuberculosis and self-care. After nursing care, the patient was free from complications during the critical period. He gained sufficient knowledge to care for himself. Continued follow-up within the prison system led to the implementation of a comprehensive tuberculosis care system and proactive measures to identify those in contact with the disease, resulting in a reduction in tuberculosis incidence in the prison.

Keywords : Case study, Nursing care, Tuberculosis pleuritis