Introduction

Global Burden of Tuberculosis

Tuberculosis (TB) remains a leading cause of death from infectious diseases worldwide, second only to COVID-19 in recent years. According to the World Health Organization (WHO, 2024), an estimated 10.8 million people developed TB in 2023, with 1.25 million deaths, marking a continued struggle in TB control despite advancements in medical interventions. The disease disproportionately affects low- and middle-income countries (LMICs), which account for over 85% of TB cases globally, with over 67% of TB cases occurring in eight nations: India, China, Indonesia, the Philippines, Pakistan, Nigeria, Bangladesh, and South Africa (WHO, 2024).

Although TB incidence has slightly declined due to global efforts such as the End TB Strategy, the emergence of multidrug-resistant TB (MDR-TB) and extensively drug-resistant TB (XDR-TB) presents a severe setback. Globally, the estimated proportion of new TB cases with MDR/RR-TB changed from 4.1% in 2015 to 3.2% in 2023; the estimated proportion of previously treated cases with MDR/RR-TB was 20% in 2015 and 16% in 2023 (WHO, 2024). The spread of totally drug-resistant TB (TDR-TB)—which resists all known anti-TB medications—poses an even greater threat to global TB eradication efforts.

Beyond antimicrobial resistance, social determinants of health significantly contribute to TB transmission and severity. Risk factors such as poverty, malnutrition, overcrowding, HIV/AIDS, diabetes, and substance abuse increase susceptibility to TB infection and progression to active disease (Syamsir et al., 2024). Additionally, the impact of climate change—through forced migration, food insecurity, and weakened healthcare infrastructures—has been recognized as an emerging challenge in TB control​.

Social and Environmental Determinants of TB

Beyond antimicrobial resistance, social determinants of health play a significant role in TB transmission and progression. Major risk factors include:

• Poverty and Malnutrition: Undernutrition contributes to approximately 1.2 million new TB cases annually, making it the leading risk factor.
• Overcrowding and Poor Living Conditions: High population density in urban slums facilitates rapid TB spread.
• HIV/AIDS: Nearly 660,000 TB cases in 2023 were among people living with HIV, underscoring the need for integrated TB-HIV management.
• Diabetes and Substance Abuse: These conditions weaken immune defenses, increasing TB susceptibility.

Climate Change and TB

Emerging research highlights the impact of climate change on TB epidemiology. WHO has identified three key pathways linking climate change to TB:

1. Food Insecurity and Undernutrition: Climate-induced food shortages exacerbate malnutrition, a major TB risk factor.
2. Displacement and Migration: Natural disasters and conflicts force populations into overcrowded conditions, accelerating TB transmission.
3. Healthcare Disruptions: Extreme weather events compromise TB diagnosis and treatment programs​.

Tuberculosis in the United States and High-Income Nations

While TB incidence in the United States (U.S.) has significantly declined due to robust public health interventions, the disease persists in high-risk populations, including:

• Homeless individuals
• Incarcerated persons
• Intravenous drug users
• Recent immigrants from high TB-burden regions
• People with immunosuppressive conditions (HIV/AIDS, diabetes, cancer)​.

According to the Centers for Disease Control and Prevention (CDC, 2024), 8,300 new TB cases were reported in the U.S. in 2023, with a case rate of 2.5 per 100,000 people​. However, Latent TB Infection (LTBI) remains a significant concern, with an estimated 13 million Americans carrying dormant TB bacteria. Without treatment, 5–10% of LTBI cases will progress to active TB, posing a continued transmission risk (UpToDate, 2024).

Pathophysiology and Transmission of Tuberculosis (TB)

Pathophysiology of Tuberculosis

Tuberculosis (TB) is caused by Mycobacterium tuberculosis (M. tuberculosis), an obligate aerobic, acid-fast bacillus that primarily infects the lungs but can also disseminate to extrapulmonary sites such as the lymph nodes, bones, kidneys, meninges, and central nervous system. This pathogen is uniquely characterized by its waxy cell wall composed of mycolic acids, which makes it resistant to desiccation, weak disinfectants, and host immune defenses.

Upon inhalation, M. tuberculosis bacilli travel through the respiratory tract and reach the alveoli, where they are engulfed by alveolar macrophages. However, the bacilli evade destruction by inhibiting phagosome-lysosome fusion, allowing intracellular survival and replication. In response, the host immune system activates a cell-mediated immune response, forming granulomas—a hallmark of TB. Granulomas are composed of macrophages, T lymphocytes, and Langhans giant cells, encapsulating the bacilli to prevent systemic spread.

In most immunocompetent individuals, this immune response results in latent TB infection (LTBI), where M. tuberculosis remains dormant but viable within granulomas. However, in about 5–10% of cases, particularly among immunocompromised individuals (e.g., those with HIV/AIDS, diabetes, or malnutrition), latent TB can progress to active TB disease.

There are three primary stages of TB progression:

1. Primary TB – Initial infection occurs, usually asymptomatic or presenting with mild flu-like symptoms. In some cases, the infection spreads, forming a Ghon focus (primary lesion). If nearby lymph nodes are involved, a Ghon complex develops, which may calcify over time into a Ranke complex​.
2. Latent TB Infection (LTBI) – The immune system successfully contains the bacteria within granulomas. The individual is asymptomatic and non-contagious but retains a lifelong risk of reactivation​.
3. Reactivation TB (Secondary TB) – Dormant bacilli become active, typically affecting the upper lung lobes. This form is characterized by caseous necrosis, cavitation, and fibrosis, with symptoms such as chronic cough, hemoptysis, weight loss, night sweats, and fever​.

Mode of Transmission

TB is primarily transmitted through airborne droplet nuclei expelled when an infected individual coughs, sneezes, speaks, or even sings. Droplets measuring 1–5 microns in diameter can remain suspended in the air for hours and be inhaled deep into the alveoli of susceptible individuals​.

Several factors influence the risk of TB transmission, including:

• Proximity and Duration of Contact – Close and prolonged exposure to an infectious TB patient increases the likelihood of inhaling viable bacilli.
• Bacterial Load – The degree of infectiousness depends on the number of bacilli expelled by the infected individual, which is higher in those with cavitary pulmonary TB.
• Environmental Conditions – Poorly ventilated, crowded, and enclosed spaces (e.g., prisons, homeless shelters, refugee camps, and healthcare facilities) facilitate TB transmission.
• Immune System Competence – Individuals with compromised immunity (e.g., HIV/AIDS, diabetes, malnutrition, or those on immunosuppressive therapy) are more susceptible to TB infection and progression to active disease.

Populations at the highest risk of TB exposure include:

• Healthcare workers and laboratory personnel handling TB specimens.
• Household contacts of active TB patients.
• Residents of congregate settings such as prisons, long-term care facilities, and homeless shelters.
• Immunocompromised individuals, including those with HIV/AIDS, diabetes, cancer, or those receiving chemotherapy and immunosuppressive therapy​.

Disease Progression and Complications of Tuberculosis

Tuberculosis (TB) follows a complex disease progression, influenced by host immunity and bacterial virulence. Once Mycobacterium tuberculosis is inhaled, it reaches the alveoli, where macrophages attempt to contain it. Depending on immune response effectiveness, TB can follow one of several pathways:

Latent TB Infection (LTBI)

• Immune Containment: In about 90% of infected individuals with intact immune function, the immune system encapsulates the bacteria within granulomas, preventing active disease.
• Asymptomatic Phase: Individuals remain symptom-free and non-contagious, but 5–15% of cases will reactivate, especially in immunocompromised individuals (HIV, diabetes, or malnutrition).
• Risk of Reactivation: Reactivation risk increases in the presence of immunosuppressive conditions, including organ transplantation, silicosis, and malignancies.

Primary TB (Active Initial Infection)

• Symptom Development: Affects about 10% of infected individuals, particularly those with weakened immune defenses (e.g., children, elderly, and immunosuppressed individuals)​.
• Pulmonary Manifestations: Initial infection may be asymptomatic or present as a mild flu-like illness. In some cases, the infection spreads, forming a Ghon focus (primary lesion) or Ghon complex when adjacent lymph nodes are involved.
• Potential Progression: In individuals with weak immune responses, primary TB can progress rapidly, leading to miliary TB, pericarditis, meningitis, or other extrapulmonary forms.

Reactivation TB (Post-primary TB)

• Dormant Bacilli Activation: This occurs when the immune system fails to suppress latent TB, leading to bacterial proliferation, particularly in the upper lobes of the lungs.
• Clinical Presentation: Characterized by pa ersistent cough, hemoptysis (coughing blood), weight loss, night sweats, fever, and progressive lung cavitation.
• Infectiousness: Reactivation TB is highly contagious, requiring prompt isolation and treatment.

Complications of Tuberculosis

TB can lead to severe systemic and organ-specific complications:

1.   Pulmonary Complications

• Cavitary TB: Extensive lung destruction due to necrotizing granulomas.
• Bronchiectasis: Permanent airway dilation due to chronic inflammation.
• Pneumothorax: Air leakage from lung cavities into the pleural space.
• Hemoptysis: Severe bleeding from TB-affected lung tissue.

2.   Extrapulmonary TB

• Miliary TB: Disseminated TB affects multiple organs, leading to weight loss, fever, and respiratory failure.
• TB Meningitis: Central nervous system involvement causing headaches, seizures, and neurological deficits.
• Pott’s Disease: Spinal TB leading to vertebral collapse and kyphosis.
• Renal TB: Can cause pyelonephritis and sterile pyuria.

3.   Systemic and Rare Complications

• Venous Thromboembolism (VTE): TB induces a hypercoagulable state, increasing the risk of deep vein thrombosis (DVT) and pulmonary embolism (PE).
• Septic Shock: TB-related sepsis has high mortality rates (79%), requiring rapid antimicrobial therapy.
• TB-associated Lung Cancer: Chronic TB inflammation is linked to a 2.1-fold increased risk of lung cancer.

Clinical Manifestations of Pulmonary Tuberculosis

Pulmonary tuberculosis (TB) presents with a wide range of symptoms that vary in severity based on the disease stage, host immune response, and the resence of comorbidities. While many individuals with latent TB infection (LTBI) remain asymptomatic, those with active TB develop characteristic clinical manifestations affecting both the pulmonary and systemic systems.

Primary Symptoms of Active Pulmonary TB

Active TB is typically insidious in onset and may mimic other respiratory infections in its early stages. The most common symptoms include:

✔ Persistent Cough (≥3 Weeks): Chronic cough, initially dry, progresses to a productive cough with purulent sputum. As the disease advances, hemoptysis (blood-streaked sputum) can occur due to cavitary lung lesions and bronchial erosion​.

✔ Fever and Night Sweats: A hallmark symptom of TB, fever is typically low-grade in early disease but becomes diurnal (peaking in the afternoon/evening and resolving at night). Night sweats are more common in advanced TB​.

✔ Unintentional Weight Loss and Anorexia: TB leads to significant weight loss due to the systemic inflammatory response and increased metabolic demand, commonly termed “consumption”​.

✔ Pleuritic Chest Pain and Dyspnea: Pleuritic pain occurs due to pleural involvement, often with effusions. Dyspnea can result from extensive parenchymal damage, effusions, or TB-related pneumothorax.

✔ Fatigue and Generalized Weakness: The body’s prolonged inflammatory response, coupled with poor oxygen exchange in the lungs, contributes to profound fatigue.

Less Common Symptoms and Atypical Presentations

While pulmonary symptoms dominate, TB can present with extrapulmonary and systemic signs:

✔ Clubbing of the Fingers: A late-stage finding, digital clubbing can be seen in chronic pulmonary TB due to prolonged hypoxia.

✔ Laryngeal TB: Hoarseness and odynophagia (painful swallowing) can result from laryngeal involvement, which is highly contagious.

✔ Gastrointestinal TB Symptoms: Patients may develop dysphagia, abdominal pain, or diarrhea due to swallowing infected secretions or GI tract involvement.

✔ Extrapulmonary TB Signs: TB can disseminate to the meninges (meningitis), lymph nodes (scrofula), bones (Pott’s disease), pericardium (pericarditis), and kidneys (sterile pyuria).

Factors Influencing TB Symptom Severity

The clinical manifestations of TB can vary significantly depending on:

✔ Host Immunity: Immunocompromised patients (e.g., HIV/AIDS, diabetes, malignancy) often present with more severe or atypical symptoms, such as absent cavitation but widespread lung infiltration.

✔ Age: Older adults may exhibit fewer respiratory symptoms but present with anorexia, weight loss, and hypoalbuminemia, which may delay diagnosis.

✔ Nutritional Status: Malnutrition weakens immune defenses, increasing the likelihood of TB reactivation and systemic spread.

Multidrug-resistant and Extensively Drug-Resistant TB

Tuberculosis (TB) remains a major public health challenge, with drug-resistant strains posing a significant threat to global TB control efforts. According to the World Health Organization (WHO), drug-resistant TB cases are increasing, necessitating urgent attention and more effective treatment strategies​.

Types of Drug-Resistant Tuberculosis

The WHO categorizes drug-resistant TB based on the level of resistance exhibited by Mycobacterium tuberculosis against different anti-TB drugs. The major classifications include:

1. Isoniazid-Resistant Tuberculosis (Hr-TB)

• Resistant to isoniazid (INH) but susceptible to rifampicin (RIF) and other first-line drugs​.

2. Rifampicin-Resistant Tuberculosis (RR-TB)

• Resistant to rifampicin, a key first-line TB drug. RR-TB is often an indicator of potential multidrug resistance​.

3. Multidrug-Resistant Tuberculosis (MDR-TB)

• Defined as TB resistant to both isoniazid and rifampicin, the two most effective first-line anti-TB drugs.
• MDR-TB requires second-line treatment regimens that are more toxic, expensive, and lengthy, with lower treatment success rates (approximately 60%).

4. Pre-Extensively Drug-Resistant Tuberculosis (Pre-XDR-TB)

• MDR-TB is also resistant to any fluoroquinolone, a key second-line drug class.

5. Extensively Drug-Resistant Tuberculosis (XDR-TB)

• A severe form of MDR-TB that is resistant to rifampicin, any fluoroquinolone, and at least one of either bedaquiline or linezolid.
• XDR-TB significantly reduces treatment options and is associated with high mortality rates.

6. Totally Drug-Resistant Tuberculosis (TDR-TB)

• TDR-TB is resistant to all known first-line and second-line anti-TB drugs, making it virtually untreatable.

Conclusion

Pulmonary tuberculosis (TB) remains a major public health threat worldwide, particularly in low- and middle-income countries where healthcare resources are limited. Despite global efforts such as the WHO’s End TB Strategy, the disease continues to impact millions annually. Early detection, comprehensive infection control, and strict adherence to long-term treatment regimens are critical to curbing its spread. The rise of multidrug-resistant TB (MDR-TB) and extensively drug-resistant TB (XDR-TB) further complicates disease management, highlighting the urgency for advanced diagnostics, innovative treatment options, and increased global collaboration.

The Role of Healthcare Professionals in TB Management

Nurses and other frontline healthcare workers play a pivotal role in TB prevention, treatment, and patient education. Their responsibilities include:

• Enhancing Treatment Adherence – Implementing Directly Observed Therapy (DOT) ensures that patients complete their prescribed TB regimens, reducing the risk of drug resistance.
• Public Awareness and Education – Educating communities about TB transmission, early symptom detection, and infection control measures is key to preventing outbreaks.
• Early Screening and Diagnosis – Conduct proactive risk assessments in high-risk populations, including immunocompromised individuals and those in overcrowded environments (e.g., prisons, refugee camps, and shelters).
• Collaboration with Public Health Authorities – Working with government agencies and global health organizations to enhance TB control strategies, vaccination programs, and outbreak response efforts.

Future Directions in TB Control

Addressing the global TB epidemic requires multifaceted solutions, including:

• Developing more effective vaccines – Research into next-generation TB vaccines is crucial for long-term disease eradication.
• Improving Rapid Diagnostic Tools – Expanding access to nucleic acid amplification tests (NAATs) and other molecular-based diagnostics will facilitate early TB detection and drug-resistance screening.
• Strengthening Global Healthcare Systems – Increased funding and policy support are needed to enhance TB surveillance, patient care, and treatment accessibility, particularly in high-burden regions.

Pulmonary tuberculosis is a preventable and treatable disease, yet it continues to pose significant health challenges worldwide. With advancements in medical research, improved healthcare policies, and strong community engagement, the goal of eliminating TB as a global health threat is achievable. A coordinated, interdisciplinary approach—involving governments, healthcare providers, researchers, and community organizations—is essential to eradicating tuberculosis and ensuring better health outcomes for future generations.

Nursing Care Planning for Clients Diagnosed with PTB

Key Focus Areas in Nursing Care for PTB

Nursing care planning for PTB should prioritize:
✔ Ensuring uninterrupted adherence to the full therapeutic regimen to prevent drug resistance.
✔ Preventing disease transmission by implementing airborne precautions and educating patients.
✔ Promoting respiratory function through effective airway clearance techniques.
✔ Addressing malnutrition and weight loss to strengthen immune defenses.
✔ Managing fatigue and activity intolerance to support daily functioning.
✔ Providing emotional and psychological support to address stigma and barriers to care.

One of the most effective strategies for TB management is Directly Observed Therapy (DOT), where healthcare providers or trained personnel supervise medication intake to improve adherence and reduce the risk of multidrug-resistant TB (MDR-TB) (WHO, 2024).

Key Nursing Diagnoses for PTB

Nursing Diagnosis	Related To (R/T)	Evidence / Risk Factors
Risk for Infection	Airborne transmission and inadequate immune defenses	Positive sputum smear, active TB symptoms, prolonged exposure in crowded settings, weakened immunity (HIV, malnutrition, diabetes, chemotherapy)
Ineffective Airway Clearance	Thick secretions, fatigue, lung tissue destruction	Productive cough, dyspnea, rales, wheezing, respiratory distress
Imbalanced Nutrition: Less than Body Requirements	Increased metabolic demand, anorexia, malabsorption	Weight loss, muscle wasting, loss of appetite, medication side effects
Activity Intolerance	Fatigue, dyspnea, impaired oxygenation	Weakness, rapid heart rate with exertion, shortness of breath, low energy levels
Risk for Ineffective Health Management	Complex medication regimen, socioeconomic barriers, stigma	Missed doses, lack of knowledge about TB treatment, financial constraints, reluctance to seek care

Nursing Diagnosis 1: Risk for Infection

Pathophysiology & Rationale

Tuberculosis is an airborne bacterial infection transmitted through inhalation of droplet nuclei. The risk of infection depends on:

• Bacterial load in the infected person’s sputum.
• Prolonged close contact in crowded or poorly ventilated environments (e.g., households, prisons, homeless shelters).
• Host immune defenses, as HIV, malnutrition, diabetes, and chemotherapy increase TB susceptibility.
• Environmental factors, including poor hygiene and lack of access to healthcare.

Expected Outcomes

✔ The patient will demonstrate an understanding of infection prevention strategies (e.g., cough etiquette, mask use, hand hygiene).
✔ The patient will adhere to airborne precautions until deemed non-infectious.
✔ The patient will complete the full TB treatment regimen without interruption.
✔ Close contacts will be identified and screened to prevent further transmission.

Nursing Interventions and Rationales

Interventions	Rationale
Monitor vital signs regularly, including temperature, respiratory rate, and oxygen saturation.	Early detection of fever and respiratory changes helps identify worsening infection.
Assess lung sounds (rales, wheezing, bronchial breath sounds) and monitor sputum characteristics.	Detects worsening lung involvement, airway obstruction, or secondary infections.
Identify close contacts and screen them for TB exposure (e.g., Mantoux tuberculin skin test, IGRA, chest X-ray).	Helps prevent further transmission and allows for early prophylaxis in at-risk individuals.
Educate the patient on airborne transmission and proper cough etiquette (covering mouth, using tissues, wearing a mask).	Reduces droplet transmission and lowers infection spread in household and community settings.
Encourage isolation in a well-ventilated room until sputum smears are negative.	Prevents exposure of uninfected individuals while the patient is infectious.
Ensure adherence to Directly Observed Therapy (DOT).	Improves treatment success rates and reduces drug resistance and relapse risk (WHO, 2024).
Administer prescribed anti-TB medications (Isoniazid, Rifampin, Pyrazinamide, Ethambutol).	Kills M. tuberculosis and prevents progression to severe TB or drug-resistant TB.
Monitor for hepatotoxicity (ALT, AST) and visual disturbances in patients on TB medications.	Isoniazid and Rifampin can cause liver damage, while Ethambutol may cause optic neuritis.

Nursing Diagnosis 2: Ineffective Airway Clearance

Pathophysiology & Rationale

Pulmonary tuberculosis (PTB) causes bronchial obstruction, inflammation, and excessive mucus production, leading to airway narrowing, dyspnea, and impaired gas exchange. Persistent coughing, hemoptysis (bloody sputum), and lung cavitation further contribute to ineffective airway clearance, increasing the risk of atelectasis (lung collapse) and secondary bacterial infections (UpToDate, 2024).

Factors that worsen airway clearance in PTB include:

• Thick, purulent, or bloody sputum due to lung inflammation and necrosis.
• Fatigue and weak cough effort, reducing secretion clearance.
• Tracheal or bronchial inflammation, leading to airway narrowing and obstruction.

Expected Outcomes

✔ The patient will demonstrate effective coughing and clear lung sounds with improved airway clearance.
✔ The patient will maintain adequate oxygenation (SpO₂ ≥ 92% or baseline if chronic lung disease is present).
✔ The patient’s sputum production will decrease, and secretions will be thinner and easier to expectorate.

Nursing Interventions and Rationales

Interventions	Rationale
Assess breath sounds and work of breathing regularly.	Helps detect airway obstruction, consolidation, or worsening respiratory distress, allowing for early intervention.
Monitor cough effectiveness and sputum characteristics (color, consistency, presence of blood).	Provides insight into airway clearance efficiency and possible complications like hemoptysis or secondary infection.
Encourage deep breathing exercises and incentive spirometry.	Promotes lung expansion, prevents atelectasis, and improves mucus clearance.
Position the patient in a semi-Fowler’s or high-Fowler’s position.	Optimizes lung expansion and reduces respiratory effort, making it easier for the patient to breathe.
Encourage fluid intake (≥2.5 L/day), unless contraindicated.	Thins mucus secretions, making them easier to expectorate.
Instruct the patient in postural drainage and chest physiotherapy when indicated.	Uses gravity-assisted positioning to mobilize secretions and enhance airway clearance.
Administer prescribed bronchodilators and mucolytics.	Reduces bronchospasm and decreases mucus viscosity, improving airflow and secretion clearance.
Provide oxygen therapy in cases of severe hypoxia.	Maintains adequate oxygenation and prevents respiratory failure.
Prepare for emergency interventions (e.g., intubation) if airway obstruction worsens.	Ensures rapid response in case of acute airway compromise due to severe obstruction.

Nursing Diagnosis 3: Imbalanced Nutrition: Less than Body Requirements

Pathophysiology & Rationale

Many patients with pulmonary tuberculosis (PTB) suffer from severe weight loss, malnutrition, and muscle wasting, which can compromise immunity and delay recovery. The chronic inflammation and metabolic demands of TB lead to cachexia, micronutrient deficiencies, and protein-energy malnutrition (PEM), further exacerbating fatigue and physical deterioration (WHO, 2024).

Key factors contributing to nutritional imbalance in TB patients include:

• Fatigue and anorexia resulting from prolonged infection.
• Increased metabolic demand due to chronic inflammation and immune activation.
• Altered taste perception and nausea caused by anti-TB medications.
• Gastrointestinal disturbances, including nausea, vomiting, diarrhea, and hepatotoxicity from treatment.

Expected Outcomes

✔ The patient will maintain a stable weight or show gradual weight gain.
✔ The patient will consume sufficient daily caloric intake to meet metabolic needs.
✔ The patient will demonstrate improved appetite and nutritional status through dietary modifications.
✔ The patient’s serum albumin and prealbumin levels will indicate adequate protein status.

Nursing Interventions and Rationales

Interventions	Rationale
Monitor weight, BMI, and serum albumin/prealbumin levels.	Helps assess nutritional status and track the effectiveness of interventions.
Assess dietary intake and gastrointestinal symptoms (e.g., nausea, vomiting, diarrhea).	Identifies barriers to adequate nutrition, allowing for targeted interventions.
Encourage small, frequent meals with high-protein, high-calorie foods.	Counters anorexia and promotes adequate caloric intake despite decreased appetite.
Educate the patient on the importance of micronutrients (e.g., vitamin D, iron, zinc) to enhance immune function.	Micronutrient deficiencies are common in TB patients, and supplementation helps support immunity and recovery.
Promote oral hygiene before meals to minimize medication-induced taste alterations.	Reduces metallic taste or bitterness caused by TB medications, improving food intake.
Encourage fluid intake (≥2L/day) unless contraindicated.	Prevents dehydration and supports digestion and medication metabolism.
Refer the patient to a dietitian for personalized meal planning and nutritional support.	A dietitian can provide tailored recommendations to ensure the patient meets nutritional requirements.
Administer antiemetics or appetite stimulants as needed.	Helps control nausea and improve appetite, promoting better food intake.
Monitor liver function (ALT, AST) for drug-induced hepatotoxicity, which can impair nutrient absorption.	Isoniazid and Rifampin can cause liver toxicity, leading to malabsorption and worsening nutritional deficits.

Pulmonary Tuberculosis Nursing Care Plan Samples

Pulmonary-Tuberculosis-Nursing-Care-Plan-Samples-final

References

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