Dang Case Study - A Businessman - Nursing Assignment Help

Assignment Task:

Case Study:

The microbiologist from the local laboratory notifies the TB Service that a surgical specimen obtained from a patient with an infected anal fistula is Polymerase Chain Reaction (PCR) test "positive" for Mycobacterium Tuberculosis Complex. The patient's admission weight was 68kg. No chest x-ray examination was performed on this patient during admission. The patient was discharged from hospital 3 days ago and is currently being visited at home by the community nurse. The nurse is attending daily irrigation and packing of his surgical wound. 

The patient is a 28-year-old businessman called Dang, who arrived from Thailand 2 years prior. He lives in a 2 bedroom apartment with his wife and 2 children. Shortly after arrival in Australia, Dang was tested for latent TB infection prior to commencing infliximab infusions for longstanding ankylosing spondylitis. His tuberculin skin test was reported as positive and interferon gamma release assay was reported as indeterminate. Dang completed a 4 month course of Rifampicin thereafter.

Use the information provided in the case study to develop a comprehensive clinical management plan for the patient. Please address the following in your responses: 

1. Discuss the significance of the laboratory result received from the microbiologist. 
2. Using current literature, discuss Dang's risk factors for latent TB infection and progression to active TB disease. 
3. Critically analyse the clinical information provided in the scenario to identify any gaps that may impact on the patient's care needs and health outcomes. Specify the further assessment and /or investigations that would need to be undertaken to address these gaps. 
4. Discuss disease containment strategies that would be incorporated into Dang's clinical management plan to address TB transmission risks identified in the scenario. 5. Using evidence-based practice guidelines and the literature together with Dang's clinical information, describe and justify the TB treatment regimen and medication management plan that will likely be prescribed for him. Include treatment goals, the projected length of treatment and supportive measures that will be implemented to achieve treatment goals. 

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