5 Nursing Diagnosis for TB Tuberculosis
Tuberculosis (TB) is a chronic infectious disease caused by Mycobacterium tuberculosis, commonly affecting the lungs (pulmonary TB). It spreads through airborne droplets released when an infected individual coughs, speaks, or sneezes. Effective nursing care is essential to support symptom management, prevent transmission, ensure treatment adherence, and promote patient well-being. Below are five nursing diagnoses commonly used in caring for patients with tuberculosis, complete with goals, interventions, and rationales.
Understanding the Role of Nursing in TB Care
The nurse plays a multidimensional role in TB management, which includes:
- Assessing respiratory status and monitoring therapy response
- Teaching cough etiquette and infection control practices
- Promoting adherence to anti-tuberculosis medication regimens (often long-term)
- Providing psychosocial support and addressing stigma
- Coordinating care with public health services for follow-up and community safety
1. Ineffective Airway Clearance related to increased sputum production and bronchial inflammation
Goal: Patient maintains a clear airway, demonstrated by effective cough, normal breath sounds, and stable oxygen saturation.Interventions:
- Monitor breath sounds, respiratory rate, and sputum characteristics every shift.
- Encourage deep-breathing exercises and controlled coughing techniques.
- Provide humidified oxygen if prescribed.
- Position patient in semi-Fowler’s position to enhance lung expansion.
These interventions improve ventilation and facilitate mobilization of secretions, reducing airway obstruction risk.
2. Impaired Gas Exchange related to alveolar inflammation and consolidation
Goal: Patient demonstrates improved oxygenation with reduced dyspnea and adequate oxygen saturation.Interventions:
- Monitor SpO₂ continuously or as ordered.
- Administer supplemental oxygen and titrate to maintain target saturation.
- Encourage proper positioning, such as elevating the head of the bed.
- Collaborate with respiratory therapy for bronchial hygiene therapy if indicated.
Improving ventilation-perfusion matching supports adequate tissue oxygenation and reduces respiratory distress.
3. Risk for Infection Transmission related to airborne droplets from active TB
Goal: Prevent transmission to healthcare workers, family, and community contacts.Interventions:
- Place patient in Airborne Isolation when available.
- Ensure use of N95 or FFP2 masks for staff and a surgical mask for the patient if outside the room.
- Teach cough hygiene: cover mouth when coughing, proper tissue disposal, and hand washing.
- Coordinate public health follow-up for contact tracing and community support.
Strict adherence to airborne precautions is essential to prevent transmission and control outbreaks.
4. Imbalanced Nutrition: Less Than Body Requirements related to decreased appetite and catabolic effects of illness
Goal: Patient maintains adequate nutrition to support immune function and recovery.Interventions:
- Monitor weight weekly and assess dietary intake.
- Encourage high-protein, nutrient-dense foods and small frequent meals.
- Consult dietitian for individualized nutritional planning.
- Address nausea or fatigue that interferes with eating.
Adequate nutrition strengthens immune response and supports tissue repair during recovery.
5. Knowledge Deficit related to lack of understanding about TB disease and medication regimen
Goal: Patient correctly explains treatment, medication purpose, and infection control practices.Interventions:
- Provide clear education about TB transmission and the importance of completing treatment.
- Explain anti-TB medications and common side effects (e.g., hepatotoxicity, neuropathy).
- Encourage follow-up appointments and discuss Directly Observed Therapy (DOT) if available.
- Use teach-back method to confirm understanding.
Education increases adherence and reduces risk of treatment failure and drug-resistant TB.
Summary Table (Quick Reference)
| Nursing Diagnosis | Focus of Care |
|---|---|
| Ineffective Airway Clearance | Promoting secretion removal and improving breathing |
| Impaired Gas Exchange | Improving oxygenation and ventilation |
| Risk for Infection Transmission | Preventing spread of TB to others |
| Imbalanced Nutrition | Supporting caloric and protein intake |
| Knowledge Deficit | Education on disease, treatment, and prevention |
References
- World Health Organization (WHO). Tuberculosis: Key Facts. https://www.who.int/health-topics/tuberculosis
- Centers for Disease Control and Prevention (CDC). Tuberculosis (TB). https://www.cdc.gov/tb
- American Thoracic Society, CDC, and Infectious Diseases Society of America. TB Treatment Guidelines.