Tuberculosis Case Study
Ray
Demographics:
Race: Asian
Gender: Male
Age: 27
Height: 5 ft 9 in
Weight: 185
Home: North Highlands, CA
Physical Assessment:
Patient appears tired, slight coughing, and just seems a little under the weather.
Mental Assessment:
Depressed
Anxious
Social Assessment:
Was homeless for a while
Spent some time in Prison
IV drug user to fit in with friends
Alcoholic
Medical Assessment:
Patient has HIV
Bad cough
Pain in chest
Coughing up blood
TB confirmed with a chest X-Ray
Dental Assessment:
Patient is missing teeth #1,2,5,12,14,16, 17,and 32
Tender lymph nodes
Generalized heavy calculus
Amalgam restorations on # 3, 15,18,30,and 31margins look suspicious
Extra Oral Exam:
Sweaty, swollen lymph nodes, broken capillaries on cheeks- patient states is from coughing so hard.
Intra-oral Exam:
Oral lesion on dorsum of tongue
Communication:
Q: Have you been around anyone with active TB?
A: Yes.
Q: Do you have active TB?
A: Yes, I had a positive chest X-Ray.
Q: Have you had a persistent cough for more than three weeks?
A: Yes.
Q: Does your cough produce blood?
A: Yes.
Q: Do you wake up throughout the night sweating?
A: Yes.
Q: Have you had unexplained weight loss?
A: Yes.
Appointment Planning:
Patient needs to be isolated from others and immediately referred to a physician. They can return for a cleaning only after they have been cleared by a physician and six months after finishing medical treatment.
Client Positioning:
Not relevant in this situation.
DH Procedures:
We do not perform elective care on patients with active TB. A TB patient can be seen for dental treatment in a hospital setting only when there is a dental emergency.
Safety Precautions:
Isolate the patient and refer to a physician immediately.
OHI:
Reiterate tooth brushing methods, and flossing with a “c” shaped curve, recommend Biotene for xerostomia from medications (Isoniazid), counsel patient to limit spread of disease, follow up appt with a phone call and pamphlets about TB.
Personal Reflection:
I chose to do my assignment on TB because it was one of those diseases that I never really knew anything about. I’ve heard people talking about it before and have been very curious about the signs and symptoms that a person would have. I also felt like I wouldn’t know how to recognize the signs or how to handle them if I ever came across someone infected with TB. After doing this assignment I now feel like I would be much more prepared and confident when dealing with a patient with TB. I haven’t ever known anyone who has suffered from TB, but after hearing the stories in class about how people use to be quarantined when they had it, I wanted to know more about the disease.
Additional Information:
http://www.youtube.com/watch?v=gruBIZ0Bm-I
Ray
Demographics:
Race: Asian
Gender: Male
Age: 27
Height: 5 ft 9 in
Weight: 185
Home: North Highlands, CA
Physical Assessment:
Patient appears tired, slight coughing, and just seems a little under the weather.
Mental Assessment:
Depressed
Anxious
Social Assessment:
Was homeless for a while
Spent some time in Prison
IV drug user to fit in with friends
Alcoholic
Medical Assessment:
Patient has HIV
Bad cough
Pain in chest
Coughing up blood
TB confirmed with a chest X-Ray
Dental Assessment:
Patient is missing teeth #1,2,5,12,14,16, 17,and 32
Tender lymph nodes
Generalized heavy calculus
Amalgam restorations on # 3, 15,18,30,and 31margins look suspicious
Extra Oral Exam:
Sweaty, swollen lymph nodes, broken capillaries on cheeks- patient states is from coughing so hard.
Intra-oral Exam:
Oral lesion on dorsum of tongue
Communication:
Q: Have you been around anyone with active TB?
A: Yes.
Q: Do you have active TB?
A: Yes, I had a positive chest X-Ray.
Q: Have you had a persistent cough for more than three weeks?
A: Yes.
Q: Does your cough produce blood?
A: Yes.
Q: Do you wake up throughout the night sweating?
A: Yes.
Q: Have you had unexplained weight loss?
A: Yes.
Appointment Planning:
Patient needs to be isolated from others and immediately referred to a physician. They can return for a cleaning only after they have been cleared by a physician and six months after finishing medical treatment.
Client Positioning:
Not relevant in this situation.
DH Procedures:
We do not perform elective care on patients with active TB. A TB patient can be seen for dental treatment in a hospital setting only when there is a dental emergency.
Safety Precautions:
Isolate the patient and refer to a physician immediately.
OHI:
Reiterate tooth brushing methods, and flossing with a “c” shaped curve, recommend Biotene for xerostomia from medications (Isoniazid), counsel patient to limit spread of disease, follow up appt with a phone call and pamphlets about TB.
Personal Reflection:
I chose to do my assignment on TB because it was one of those diseases that I never really knew anything about. I’ve heard people talking about it before and have been very curious about the signs and symptoms that a person would have. I also felt like I wouldn’t know how to recognize the signs or how to handle them if I ever came across someone infected with TB. After doing this assignment I now feel like I would be much more prepared and confident when dealing with a patient with TB. I haven’t ever known anyone who has suffered from TB, but after hearing the stories in class about how people use to be quarantined when they had it, I wanted to know more about the disease.
Additional Information:
http://www.youtube.com/watch?v=gruBIZ0Bm-I