Comparative case study of nursing care for patients with tuberculosis and HIV co-infection with hepatic complications from tuberculosis at Bamrasnaradura Infectious Diseases Institute

Abstract

This study examined the nursing care of pulmonary tuberculosis patients co-infected with AIDS who develop drug-induced hepatitis caused by tuberculosis medications at the Bamrasnaradura Infectious Diseases Institute. It served as a guideline for nursing personnel, employing Gordon's 11 functional health patterns for assessment and diagnosis, along with Orem's theory for nursing care planning and case management by tuberculosis clinic nurses. The focus areas included: (1) controlling and preventing tuberculosis transmission, (2) ensuring consistent medication adherence, (3) monitoring and managing medication side effects, (4) addressing nutritional status, (5) educating patients on disease prevention, infection control, and proper self-care at home, and (6) screening household contacts for tuberculosis. In the case studies of two patients, both developed drug-induced hepatitis within the first two weeks of treatment, though with varying severity. Liver function was monitored regularly, with immediate corrective actions taken upon detecting abnormalities. This involved adjusting the medication regimen and administering tolerable antiviral drugs, enabling the patients to regain a good quality of life. The strong multidisciplinary team provided comprehensive care, empowering patients and their families with the knowledge and skills needed for self-management and consistent treatment adherence.