Download Case Study, Chapter 22, Respiratory Tract Infections, Neoplasms

Case Study, Chapter 22, Respiratory Tract Infections, Neoplasms, and Childhood
Disorders
Mr. R is a migrant worker who has been in the United States for 6 months. He has been doing
odd jobs, one of which has been cleaning chicken houses. While he is waiting for official
citizenship papers, he has been unable to obtain permanent housing. He went to the health
department when he could not stop coughing. He has lost 10 pounds in the last month and just
does not feel well. (Learning Objectives: 5 and 6)
1. What additional information would be helpful?
He speaks and understands very little English, and his native language is Spanish. He has been
staying in the homeless shelter since his arrival, and he denies any significant health issues.
2. Is it significant that he has been cleaning chicken houses? Why or why not?
A tuberculin skin test was administered, and 2 days later, there is 14 mm of induration.
3. How would the nurse interpret his TB skin test?
4. How will a definitive diagnosis of TB be made?
5. What are some risk factors for TB?
6. A diagnosis of tuberculosis is confirmed in Mr. R, and he is prescribed a combination of
drugs for at least 6 months. What is the rationale for multiple drugs and the length of
treatment?