nursing

Reply to classmates’ post. At least 125 words each and 1 scholarly reference within last 5 years for each.

POST1

Tuberculosis(TB) is an infection caused by the bacteria Mycobacterium tuberculosis, an acid-fast bacillus that typically affects the lungs, however, can invade other body systems. TB is highly contagious and transmitted by airborne droplets. When inhaled, the bacteria descend into the lung periphery, where it is phagocytized by macrophages, and causes nonspecific inflammation. Some of the bacilli travel via the lymphatic system and settle in lymph nodes, where lymphocytes respond and trigger the immune response. Although the body tries to fight off the infection by engulfing the bacilli, the bacteria can survive within macrophages, resist killing by lysosomes, thereby continuing to multiple within the cell and remain dormant. Due to this process, the bacteria are can be resistant to host defenses and drug treatment (McCance & Huether, 2018).

In response to the bacteria replicating within the cell, the macrophages and lymphocytes release interferon to impede duplication. This then stimulates more macrophages to attack the bacteria. The apoptotic infected macrophages also activate cytotoxic T cells. The macrophages, lymphocytes and neutrophils seal off the colonies of bacilli, forming a tubercle, a granulomatous lesion. Tissues within the tubercle that is infected will die, forming a collagenous scar tissue around the tubercle. This completes isolation of the bacilli, which is roughly 10 days after the initial immune response (McCance & Huether, 2018). .

Immunity to TB develops once the bacilli are isolated in the tubercle and may remain dormant for life. Individuals with effective immune systems may eradicate all viable bacilli, while those with impaired immunity may have bacilli intermittently replicate. For people with no effective immunity, this can progress to active disease. With active disease, TB can spread via blood and lymph, causing extrapulmonary disease, creating neurologic deficits, meningitis symptoms, bone pain and urinary symptoms (McCance & Huether, 2018).

Due to how contagious this infection is, patient education regarding effective treatment is crucial to prevent spread. Incomplete adherence to treatment increases risk of continued transmission in the community, treatment failure, relapse and development or amplification of drug resistance. Patients should be educated on how this virus spreads, proper treatment and risks associated with lack of adherence. Research shows that education and counseling is associated with a higher rate of treatment completion (Alipanah et al. 2018). Educational information about TB, how it is spread, and treatment should be given in several formats to ensure the patient understands. This can include oral information, written information or even charts. In order to increase compliance with treatment, direct observation therapy, phone/text reminders, incentives or a mix of several strategies can be used to increase compliance with the extensive treatment for TB (Alipanah et al. 2018).

POST2

Respiratory syncytial virus (RSV) Bronchiolitis is common and almost exclusive to infants and young toddlers. RSV Bronchiolitis is a viral-induced respiratory tract infection (McCance & Huether, 2019). The prognosis is good for healthy infants while premature infants and infants with underlying health issues (such as heart disease or immune deficiency) may have a much more severe or deadly course of the infection (McCance & Huether, 2019). This is because premature infants and infants with underlying health issues have immature respiratory systems and maternal immunoglobulins do not protect against RSV infections (McCance & Huether, 2019).

Pathophysiology: RSV is an enveloped, nonsegmented, negative, single-stranded RNA virus belonging to the paramyxovirus” (Erickson, Bhakta & Mendez, 2020, p.1). The viral infection causes inflammation and necrosis of the bronchial epithelium with destruction of ciliated epithelial cells. There is infiltration with lymphocytes around the bronchioles and a cell-mediated hypersensitivity to viral antigens with release of lymphokines causing inflammation as well as activation of eosinophils, neutrophils and monocytes. The submucosa becomes edematous and cellular debris and fibrin form plugs within the bronchioles. Edema of the bronchiolar airway, accumulation of mucus and cellular debris and possibly bronchospasm narrow or occlude many peripheral airways (McCance & Huether, 2019, p. 3685). The result of the inflammation of the cells and the edema within the bronchiolar airway/mucus accumulation/cellular debris, is the obstruction in the airway that we can hear as wheezing.

Education: RSV is a virus and the majority of infants and toddlers who get RSV improve with supportive care. Supportive care includes suctioning as needed, antipyretics for fevers if needed, hydration and using a humidifier. Education focuses on prevention for RSV as in some children RSV can be deadly especially premature infants and infants with underlying health problems. RSV is a highly contagious virus and is passed through air droplets and contact droplets. It is important to teach parents the proper way to cover their childrens cough so they do not spread the virus. Equally as important is to teach proper hand washing techniques for parents. In addition, it is important to teach parents to clean their childrens toys if their children attend daycare or are around any other children. At this age many children put things in their mouth and RSV can be spread easily when a child carries the virus and puts a toy in their mouth and later another child uses the same toy or puts the same toy in their mouth.

 

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