Overview
Intestinal tuberculosis is a chronic specific infection caused by Mycobacterium tuberculosis invading the intestinal tract, and is the most common form of tuberculosis in the digestive system. It is mainly caused by swallowing sputum of Mycobacterium tuberculosis and occasionally by food contaminated with Mycobacterium tuberculosis. The incidence of the population is mostly young adults, more women than men. The pathology includes 3 types: ulcerative, proliferative and mixed. In addition to treatment, careful and thorough nursing care plays an important role in the cure of intestinal tuberculosis.
Main nursing problems
1. Pain.
2. Anxiety.
3. Nutritional disorders.
4. Activity intolerance.
5.Potential complications such as intestinal perforation, intestinal obstruction.
Nursing measures
1.Psychological care
Due to the long course of intestinal tuberculosis, repeated attacks of abdominal pain, abdominal distension and other symptoms, as well as the long duration of anti-tuberculosis treatment and the side effects of tuberculosis drugs, patients often have different degrees of anxiety, fear, depression and other emotions. Therefore, nursing staff should patiently explain to patients and their families the etiology, clinical characteristics and treatment process of the disease, encourage patients to face the disease, eliminate their negative emotions, and actively cooperate with the treatment.
2. Pain care
Observe the location, nature and duration of abdominal pain, patiently listen to the patient’s complaints of pain, massage, acupuncture and other methods can be used to relieve pain, follow the doctor’s orders to give appropriate antispasmodic, analgesic, and to observe the efficacy and adverse reactions. For patients with concomitant intestinal obstruction, they should be strictly fasting, water, and parallel gastrointestinal decompression. If the patient has severe pain, pressure pain, etc., should promptly notify the physician, and cooperate with the resuscitation.
3. Condition observation
Closely monitor the patient’s vital signs, observe and record the location, degree and duration of abdominal pain and bloating, as well as the number and amount of diarrhea. Accurately record the 24-hour in and out volume.
4. Sterilization and isolation care
Patients with intestinal tuberculosis should have a special ward, sick area with yellow isolation signs, health care workers should pay attention to wearing gloves, masks, indoor ventilation, ultraviolet disinfection, separate beds, meals, chopsticks, towels, etc., and share beds, meals, chopsticks, towels, etc., and the tableware used by the patient should be boiled and disinfected for 10-15 minutes, and the commode should be soaked in 5%-10% cresyl soap solution for 2 hours, in order to prevent cross-infections.
5. Medication care
Drugs play a decisive role in the control of tuberculosis, and the principle of using sensitive anti-TB drugs at an early stage, in combination, in the right amount, regularly and throughout the whole course of treatment is adopted in the clinic. Pay attention to observe the efficacy and adverse reactions of the drugs. For those with severe diarrhea, rehydration therapy should be given as prescribed by the doctor.
6. Dietary care
Due to abdominal pain, constipation, anorexia, emaciation, there are different degrees of malnutrition, patients should be instructed to eat high-protein, high-calorie, vitamin-rich food, avoid eating gas-producing food, avoid cold and irritating food, and those with severe diarrhea should be fasted temporarily, and observe whether there are symptoms of dehydration.
7. Complications care
Intestinal obstruction is the most common complication of intestinal tuberculosis, we should closely observe the general state of the patients, and notify the doctor promptly if we find shortness of breath, obvious decrease in the number of bowel movements, abdominal distension, nausea, vomiting.
Health promotion
1. Encourage patients to exercise properly in order to strengthen the resistance of the body.
2. Reasonable nutritional diet, regular life, maintain a good attitude.
3. Pay attention to personal hygiene and advocate meal portioning.
4. Follow the doctor’s instructions to carry out anti-tuberculosis treatment and go to the outpatient clinic regularly for follow-up.
5. Explain the manifestations of intestinal perforation, intestinal obstruction, tuberculous peritonitis and other complications, so that patients can find and consult the doctor in time.