Multidrogorresistencia de la tuberculosis en un paciente y proceso de atención de enfermería

Abstract

Introduction: Tuberculosis is an infectious disease caused by the koch bacillus, this bacterium specifically affects the lungs producing pulmonary tuberculosis. The immunity mechanisms determine the susceptibility of the host causing the individual to become infected, becoming a source of infection affecting the susceptible population. The most vulnerable age groups are children under 5 years old and adults over 65 to 70 years old. Acquired this infection there are several conditions of the pathology and that will depend on the state of immunity of the host. Objectives: To describe the multidrug-resistant trigger factors in a 73-year-old patient with multidrug-resistant tuberculosis by reviewing the clinical and bibliographic history, establishing the nursing care plan for the management of this type of patient. Methods: This descriptive type case analysis where data extracted from the patient's clinical history and bibliography manifested in an orderly and consistent manner. The data collection stage was given using the questioning of the patient in order to gather information about the disease process. The management and analysis of patient data, both objective and subjective, were carried out systematically. Results: Female patient of 73 years, Ecuadorian, born in Loja, resides in Machala, civil state, free union, occupation, domestic chores. Upon analysis of the data, the patient presented a personal history of type II diabetes mellitus of about two years and did not report family history. At the time of the first contact with health personnel, the patient presented with a clinical picture of severe headache, asthenia, diaphoresis, cough with phlegm for about 10 days, and was detected as respiratory symptomatic. To the conscious patient assessment oriented in space and person time; pale, asthenic facies; semi-moist oral reactive isochoric pupils; symmetrical thorax with pulmonary fields crackling rales and rhonchi in the right upper lobe; soft, depressible abdomen not painful on palpation, where visceromegaly or masses are not palpated, surgical scar is observed, symmetrical extremities with preserved muscle tone and strength. With your blood pressure of 100/60 mmHg, with heart rate 90 per minute, respiratory rate 20 per minute, temperature 36 ° C, oxygen saturation 98%. His anthropometric measures: weight of 35.5 kilograms, size 141 centimeters and his body mass index of 19. During the follow-up in the health center from its initial diagnosis to the present, there were both advances and setbacks and several reports indicating that it does not assist in taking the treatment, presenting its first resistance on July 25. Conclusions: It is concluded that the factors that trigger MDR tuberculosis, which we find in the patient, is the lack of knowledge about the disease, the negativity of continuing with the treatment; for this the nursing intervention should focus on education and counseling since evaluating the patient according to the theory of Virginia Henderson presents many unmet needs.