Page 698 - Saunders Comprehensive Review For NCLEX-RN

XXIII. Tuberculosis

A. Description
1. Highly communicable disease caused by
Mycobacterium tuberculosis
2. Transmitted by the airborne route

3. Multidrug-resistant strains of tuberculosis can

result from improper compliance, noncompliance
with treatment programs, or development of
mutations in tubercle bacillus.
B. Transmission
1. Transplacental transmission is rare.
2. Transmission can occur during birth through
aspiration of infected amniotic fluid.
3. The newborn can become infected from contact with
infected individuals.
C. Risk to mother: Active disease during pregnancy has been
associated with an increase in hypertensive disorders of
pregnancy.

D. Diagnosis: If a chest radiograph is required for the mother,

it is done only after 20 weeks of gestation, and a lead shield for the
abdomen is required.

Tuberculin skin testing is safe during pregnancy; however, the PHCP may want

to delay testing until after delivery.
E. Assessment

1. Mother
a. Possibly asymptomatic
b. Fever and chills
c. Night sweats
d. Weight loss
e. Fatigue
f. Cough with hemoptysis or green or
yellow sputum
g. Dyspnea
h. Pleural pain
2. Newborn
a. Fever
b. Lethargy
c. Poor feeding
d. Failure to thrive
e. Respiratory distress

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