Active Pulmonary Tuberculosis

2. Diagnosis: Active Pulmonary Tuberculosis

3. Condition:

4. Vital signs: q shift

5. Activity: Up ad lib in room.

6. Nursing: Respiratory isolation.

7. Diet: Regular

8. Special Medications:

-Isoniazid 300 mg PO qd (5 mg/kg/d, max 300 mg/d) AND Rifampin 600 mg PO qd (10 mg/kg/d, 600 mg/d max) AND Pyrazinamide 500 mg PO bid-tid (15-30 mg/kg/d, max 2.5 gm) AND Ethambutol 400 mg PO bid-tid (15-25 mg/kg/d, 2.5 gm/d max). -Empiric treatment consists of a 4-drug combination of isoniazid (INH), rifampin, pyrazinamide (PZA), and either ethambutol or streptomycin. A modified regimen is recommended for patients known to have INH-resistant TB. Patients are treated for 8 weeks with the four-drug regimen, followed by 18 weeks of INH and rifampin. -Pyridoxine 50 mg PO qd with INH.

Prophylaxis

10. Labs: CBC with differential, SMA7 and 12, LFTs, HIV serology. First AM sputum for AFB x 3 samples.

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