Direct Observation Therapy (DOT)
My preceptor and I saw a 27 year old female for direct observation therapy (DOT). DOT is a process whereby the nurse watch the client swallow his/her medications. This method is use when a person is diagnose with active tuberculosis disease to ensure compliance is met. The client in this case is diagnose with cavitary pulmonary tuberculosis (TB). Cavitating pulmonary TB is an extensive necrosis with cavitation, mostly occur in the upper portion of the lung (Public Health Agency of Canada, 2015). Saeed (2012) stated “cavitating disease occurs in 40-87% of pulmonary TB” (p. 40). Patients with cavity have a bacterial load of up to 1011 bacilli/gram, making it highly contagious (Saeed, 2012, p. 40). The presence of cavitary disease has shown
to have a high risk factor for treatment failure and relapse (Public Health Agency of Canada, 2015). However, researchers found that the combination of isoniazid, ethambutol, pyrazinamide and rifampin in highly effective in killing the bacilli completely and provides protection against relapse and resistance (Saeed, 2012). The client is taking all four medications thus, it is important to monitor for sign effects e.g. monthly blood work and vision test.
to have a high risk factor for treatment failure and relapse (Public Health Agency of Canada, 2015). However, researchers found that the combination of isoniazid, ethambutol, pyrazinamide and rifampin in highly effective in killing the bacilli completely and provides protection against relapse and resistance (Saeed, 2012). The client is taking all four medications thus, it is important to monitor for sign effects e.g. monthly blood work and vision test.