TUBERCULOSIS AMONG NATIVE AMERICANS

TUBERCULOSIS AMONG NATIVE AMERICANS: AN AGGREGATE ANALYSIS

This paper consists of an aggregate analysis of tuberculosis in Native American populations and a planned nursing response to the problem. To this end, the paper provides an overall description and assessment of the aggregate and their risk for tuberculosis. This assessment utilizes principals and concepts of both Orem's Self-Care Nursing Theory and the Natural History of Disease model.

Following the provided assessment, a nursing plan for dealing with the problem of tuberculosis in Native American populations is developed. This section of the paper includes a delineation and discussion of nursing diagnoses, prioritization of these diagnoses, basic program goals, and the implementation of the planned program with levels of prevention. The final section of the paper describes and defends methods of program evaluation.

1. American Indians - The aggregate being studied is that of Native Americans, sometimes called "American Indians." According to the American Indian Culture Resources Center (1998), American Indians are descendants of the Native people who had been living on the American continent for at least 30,000 years when Columbus "discovered" America. Five hundred years after Columbus discovered America, the Native people were divided into groups by the U.S. Government. These groups, still recognized today, are:

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" 1997). People are most likely to be contagious when their sputum contains bacilli, when they cough frequently and when the extent of their lung disease, as revealed by a chest x-ray, is great. TB is spread from person to person in microscopic droplets - droplet nuclei - expelled from the lungs when a TB sufferer coughs, sneezes, speaks, sings, or laughs. Only people at the active stage of the disease are contagious (Stead, 1997). The site of initial infection is usually the alveoli - the balloonlike sacs at the ends of the small air passages in the lungs known as bronchioles. In the alveoli, white blood cells called macrophages ingest the inhaled M. tuberculosis bacilli. Some of the bacilli may be killed immediately; others may multiply within the macrophages. Infrequently, but especially in HIV-infected people and in children, the bacilli spread to other sites in the body. This dissemination sometimes results in life-threatening meningitis and other problems. During the two to eight weeks after initial infection in people with intact immune systems, macrophages present pieces of the bacilli, displayed on their cell surfaces, to another type of white blood cell - the T cell. When stimulated, T cells release an elaborate

Category: Medical - T