PAPER ASSIGNMENT

TUBERCULOSIS

Arranged By :
Group 10

Fariza Ilham Putri Tiara Elsaby

Latifatul Isnaini Ulfi Asmaroh
Mita Puspitaningkrum Zulfa Afida Salma

NURSING STUDY PROGRAM

SEKOLAH TINGGI ILMU KESEHATAN KUSUMA HUSADA
SURAKARTA
2019
 CHAPTER I
PRELIMINARY

A. Backgraund
The incidence of tuberculosis (TB) is reported to have increased dramatically
in the last decade all over the world, including in Indonesia, this disease usually occurs in
many countries developing which has a lower middle socioeconomic level. Tuberculosis
(TB) is an infectious disease that causes death with a top / death rate high, the incidence
of diagnosis and therapy is quite long. Indosesia, TB is the main cause of death and the
highest morbidity rate after ispa. Number of TB patients from year to year in Indonesia is
increasing. At this time one patient appears every minute new tuberculosis and every two
minutes there is a new patient with infectious tuberculosis.
Tuberculosis is an infectious disease caused by the Microbacterium
Tuberculose bacteria. This bacterium is a very strong bacilli bacteria that requires a long
time to treat it. This bacterium infects the lung organs more frequently than other parts of
the human body.
Tuberculosis TB is one of the deadliest diseases in the world. The World
Health Organization WHO estimates that one third of the world's population has been
infected with Mycobacteriumtuberculosis. Tuberculosis is still one of the major health
problems in the world of TB incidence, reportedly increasing dramatically in the last
decade throughout the world. Likewise in Indonesia Tuberculosis, is a health problem
both in terms of mortality rates, rates of illness, morbidity and diagnosis and treatment.
Micobacterium tuberculosis (TB) has infected a third of the world's population, according
to WHO around 8 million of the world's population is attacked by TB with the deaths of 3
million people per year (WHO, 1993). In the country the development of this death
constitutes 25% of disease deaths that can actually be prevented. It is estimated that 95%
of TB patients are in developing countries. With the emergence of epidemic HIV / AIDS
in the world, the number of TB patients will increase. Women's deaths due to TB are
more than deaths due to pregnancy, childbirth and childbirth (WHO). WHO launched a
global emergency for TB disease in 1993 because it is estimated that TB can attack
anyone (old, young, male, female, poor, or child) and anywhere. Every year, Indonesia
 increases with a quarter of a million new cases of tuberculosis and around 140,000 deaths
occur each year caused by tuberculosis. In fact, Indonesia is the third largest country with
TB problems in the world. Surveying TB prevalence in six provinces in 1983-1993 shows
that TB prevalence in Indonesia ranging from 0.2 ± 0.65%. Whereas according to the
Global TB Control Report issued by WHO in 2004, the incidence of TB in 2002 reached
555,000 cases (256 cases / 100,000 inhabitants), and 46% of them were estimated to be
new cases.

B. Formulation of the problem

1. What is meant by tuberculosis TBC?
2. What is the etiology of tuberculosis?
3. What are the symptoms for people with tuberculosis?
4. How is the Classification of Diseases and the Type of Patients with tuberculosis?
5. How to spread Tuberculosis?
6. How do you treat and prevent Tuberculosis?

C. Writing purpose
1. To find out the meaning of tuberculosis
2. To find out the etiology of tuberculosis
3. To find out the symptoms for people with tuberculosis
4. To find out the Classification of Diseases and the Type of Patients with tuberculosis
5. To find out the spread Tuberculosis
6. To find out the treat and prevent Tuberculosis
 CHAPTER II
LITERATURE REVIEW

A. Definition of Tuberculosis
Tuberculosis (TB): an infectious disease caused by the bacterium
mycobacterium tuberculosis. TB mainly attacks the lungs as a place of primary infection.
In addition, TB can also be obtained attacks the skin, lymph glands, bones and brain
membranes.
Tuberculosis is an infectious disease caused by the Microbacterium
Tuberculose bacteria. This bacterium is a very strong bacilli bacteria that requires a long
time to treat it. This bacterium infects the lung organs more frequently than other parts of
the human body.

B. Etiology of tuberculosis
The cause is microorganism bacteria, namely: mycobacterium tuberculosis
with size 1-4 UM length and 1.3-0.6 thick UM including positive and resistant aerobgram
bacteria groups acidic acid or basil. These germs are rod-shaped, have special properties
that are resistant against acid in coloring (acid resistant bacilli). TB germs die quickly
with sun cyanars directly but survives several hours in a dark and soft place. In the
network this germ body can be dominant for several years. Germs can be spread from
sufferers Positive smear TB to people who are nearby, especially close contact with TB is
a very infectious disease. A TB disease can transmit the disease to 10 people around him.
According to WHO estimates, 1/3 of the population is currently infected mycrobacterium
tuberculosis.

C. Symptoms for People with Tuberculosis

Symptoms of TB can be divided into general symptoms and specific symptoms that arise
according to the organs involved.
1. Systemic / Main Symptoms
a. Fever is not too high which lasts a long time, usually felt at night with night
sweats. Sometimes attacks such as influenza and are intermittent.
 b. Decreased appetite and weight.
c. Coughing for more than 3 weeks (can be accompanied by blood).
d. Feeling uneasy (malaise), weak

2. Special Symptoms
a. Depending on which body organs are affected, if there is a blockage in part of the
bronchi (the channel leading to the lungs) due to suppression of enlarged lymph
glands, it will cause a "wheezing" sound, weakened breath sounds accompanied
by tightness.
b. There is liquid in the cavity pleura (lung wrapper), can be accompanied by
complaints of chest pain.
c. When it comes to bone, symptoms will occur such as a bone infection which can
one day form a channel and empties into the skin above it, the pus will emit fluid.
d. In children it can affect the brain (the lining of the brain) and is referred to as
meningitis (inflammation of the lining of the brain), symptoms are high fever,
decreased consciousness and convulsions

D. Classification of Diseases and the Type of Patients with tuberculosis

Determination of Classification and type of Tuberculosis sufferers requires a
"Case Definition" require and provide a standard limit of each classification and type of
sufferer. There are four things that need to be considered in determining case definitions,
namely:
1. Diseased organs: Lung / Extra Lung.
2. Macroscopic direct phlegm examination results: positive smear / negative smear.
3. History of previous treatment: New / already treated.
4. Severity of disease: Mild / severe.
Disease Classification
1. Pulmonary TB
Is: tuberculosis which attacks lung tissue, not including pleora (lung
membrane). Based on the results of sputum examination, pulmonary tuberculosis is
divided into:
 a. AFB Pulmonary TB
b. AFB Pulmonary TB

2. Extra pulmonary tuberculosis

Is: tuberculosis which attacks other organs besides the lung for example: pleura
(membrane) lung, lining of the brain, lining of the heart (pericardium), lymfe glands,
bones, joints, kuilit, intestine, kidney, urinary tract, genitals, and others. Based on the
level of trust. Extra pulmonary tuberculosis is divided into 2, namely:
a. Mild Lung TBC
For example: lymph node TBC, unilateral exudative pleurisy, bone (except bone)
back), joints and adrenal glands
b. Extra severe pulmonary tuberculosis
For example: Meningitis, Pericarditis, peritonitis, spinal tuberculosis, intestinal TB,
tuberculosis Urinary and genitalia

Type of Sufferer
The type of patient is found based on a history of previous treatment. There are several
types sufferers, namely:
a. New case
Are: Patients who have never been treated with OAT or have swallowed OAT less
than one month (30 daily doses).
b. Relapse (Relapse)
Are: tuberculosis sufferers who have previously received treatment tuberculosis and
has been declared cured / complete treatment, then returns to treatment with
positive smear sputum results.
c. Transfer (Transfer In)
Are: patients who are receiving treatment in another district and later moved to
medical treatment in this district. The transfer sufferers must carry a letter reference
(TB form 09).
d. Cases of treatment after failure (treatment after default / drop out).
 Is: Suffering returning to treatment with the results of sputum smear after drop out
of treatment for two months or more.
e. Failed
Is: - AFB suffering that still remains positive or returns to be positive at
end of 5th month or more.
- Suffering of positive X-ray smear that became AFB at the end of the second
month of treatment.
f. Other
All other sufferers who do not meet the above requirements. Included in this group
is a chronic case (is a patient who is still smear after completing repeat treatment
with category two.)

E. Spread Tuberculosis
Basically TB transmission is not as easy as imagined. Not everyone who
breathes air containing TB bacteria can get sick right away. Bacteria in the air can last for
hours before finally being inhaled. When inhaled, the body that has a strong immune
system will immediately kill the incoming bacteria. People who are at high risk of
contracting TB are those who often meet or dwell in the same place as sufferers, such as
family, work colleagues, or classmates.

When inhaled and the immune system does not succeed in getting rid of
bacteria, the bacteria will stay in the lungs. In most cases, inhaled bacteria will stay in the
lungs without causing disease or infecting other people. Bacteria remain in the body
while waiting for the right time to infect, which is when the immune system is low.
TB is usually transmitted through air contaminated with bacteria.
Mycobacterium tuberculosis is released when people with cough tuberculosis, and in
children source of children infected with patients with adult tuberculosis. in people with
low body capacity), and can spread through the blood or get lymph. TB can infect almost
all organs of the body such as: lungs, brain, kidneys, digestive tract, bones, lymph bones,
etc., even though the organs are most often affected by the lungs.
 Mikobakterium tuberkulosa Successfully infecting the lungs, then soon the
colonies of bacteria that form will grow round. Usually through a combination of
reactions immunologys TB bacteria will try to be inhibited through the formation of walls
around the bacteria by lung cells. The mechanism of wall formation makes the
surrounding tissue become scar tissue and TB bacteria will become dormant (break).
Forms dormant this is actually seen as a tubercle on photorontgen examination

F. Treat and Prevent Tuberculosis

Prevention of TBC
1. When coughing should cover his mouth, and if the cough is more than 3 weeks, feel
pain in the chest and difficulty breathing as soon as kepuskesmas or to the hospital.
2. When coughing, turn away so as not to hit other people.
3. Dispose of saliva in a closed place, and if the spit mixed with blood immediately
brought kepuskesmas or to the hospital.
4. Wash eating and drinking equipment until clean after being used by the sufferer.
5. Newborns and young children must be immunized with the BCG vaccine. Because the
vaccine will provide very good protection.

Tuberculosis treatment
In medicine, tuberculosis is divided into 2 parts, namely:
1. Short-term
With the procedure of treatment: every day with a period of 1-3 months with
the drug given:
1. Injection of 750 mg Streptomycin
2. Fit 10 mg
3. Ethambutol 1000 mg
4. Isoniazid 400 mg
 CHAPTER III
COVER

A. Conclusion
TB is: an infectious disease caused by mycobacterium tuberculosis most of which attack
the lungs but can also affect other organs. TB is a very infectious disease with symptoms
as follows: coughing up blood, shortness of breath, chest pain, malaise, anorexia, phlegm
mixed with blood, headache, muscle aches and night sweats. The drugs used to cure
tuberculosis are a combination of: rifamicin, isonaizid, pyrazinamid, ethambutol and
streptomycin.

B. Suggestion
Hopefully we all can better understand and know about TB disease and get it increase our
awareness, willingness and participation in TB control.
 BIBLIOGRAPHY

Brunner and Suddarth. 2011. Medical Surgical Nursing. Vol I. Jakarta: EGC
Prince A. Silvia. 2011. Pathophysiology. 4th edition. Jakarta: EGC
Doenges E. Marylin. 2010. nursing care plan. Jakarta: EGC
Pearce C. Evelyn .2008. anatomy and physiology for paramedics. Jakarta: EGC
Zulkifli Amin, Asril bahar. 20013. pulmonary tuberculosis, internal medicine textbook.
Jakarta: UI
 DIALOG

Nurse : Good morning Mr.Fahriza, how can I help you?

Patients : good morning nurse, I wanted to ask you a little about the disease tuberculosis,
can
you explain it?
Nurse : of course, maybe I can help a bit Mr.Fahriza?
Patient : What are the signs that a person has TB disease?
Nurse : Cough-cough for more than 3 weeks may be accompanied by blood
Patients : Does everyone who experienced coughing up blood means suffering from
tuberculosis?
Nurse : Not necessarily, because coughing up blood can be caused by various reasons
Patients : Tuberculosis is spread through any media?
Nurses : Through the sparks that come out with sputum when coughing, it could
be through the
dust, instrument eat / drink that contains TB germs
Patient : What is TB disease that is genetically inherited?
Nurses : TB disease is not genetically inherited, because tuberculosis disease is not
hereditary
Patient : Are people who have been cured of TB disease can be contracted again?
Nurse : It can, because after recovering from tuberculosis there is no lifelong
immunity
Patient : Can TB disease be cured completely?
Nurse : Able to follow the advice of health workers to take medication regularly
Patient : Could exposed to TB disease if we live in a clean environment?
Nurses : The possibility of contracting we will still be there, because we live not
only in our ownNeighborhood
Patient : What effects on the fetus when pregnant women were suffering from
tuberculosis?
Nurse : Usually nutritional state of patients with tuberculosis is not good, so this may
affect thedevelopment of the fetus in the womb
Patient : How does our attitude in the house when there are family members who
suffer fromtuberculosis?
Nurses : Bring the patient to the doctor to get treatment on a regular basis
Patients : Pattern of life how should we have to avoid the disease tuberculosis?
Nurses : Healthy lifestyle is the key, because we do not know when we can be
exposed to TB germs