Nursing Care of Patients with Extensively-drug Resistant Tuberculosis: Case Study

Abstract

The aim of this study was to compare the disease progression, nursing diagnosis, nursing planning, and nursing results of two patients with extensively-drug resistant tuberculosis who used the service at the Drug-resistant TB Clinic, Outpatient Department, Khon Kaen Hospital. The study was conducted from February 2017 to August 2019. The research tools included medical records, patient history interview, observation, review of the information with an expert, multidisciplinary team, and TB networks within and outside the hospital. The functional health pattern was used to determine the nursing diagnosis. The results showed that the first patient with extensively-drug resistant tuberculosis had been treated, but the treatment failed due to drug resistance. The patient and family had understanding and knowledge about the disease and treatment aimed to bring be relief from the disease. The second patient with extensively-drug resistant tuberculosis had emphysema as a comorbidity. After being treated with multi-drugs for resistant TB, it was discovered that the patient did not take the medicine regularly or make an appointment for the follow-up. As a result, they had extensively-drug resistant tuberculosis and the side-effects of the medicine. The patient’s relative had knowledge and understanding about the disease but did not follow the preventive measure for transmission. Therefore, the nurse should be able to evaluate the patient in terms of physical, mental, social, and spiritual aspects, plan the nursing care to monitor and follow up in the community. The community should take part in evaluating and taking care of the patient, so they and their family have a good quality of life and are cured of the disease. The research results should be applied to develop nursing practice guidelines and nursing standards for patients with extensively-drug resistant tuberculosis.