Nursing Care of Pulmonary Tuberculosis Patients with Hepatitis Caused by Tuberculosis Drugs: 2 Cases Study

Abstract

This comparative case study aimed to explore the pathology, physical examination, clinical manifestations, treatment, and health assessment based on Gordon’s 11 functional health patterns in two patients with pulmonary tuberculosis complicated by drug-induced hepatitis. Nursing diagnoses and care plans were developed using Orem’s theory as a framework to guide nursing care for patients with tuberculosis and associated complications. The findings revealed that Case 1 involved a 39-year-old Thai female who presented with hemoptysis, confirmed pulmonary tuberculosis in the left lung, and after 18 days of receiving first-line anti-tuberculosis drugs, developed drug-induced hepatitis with nausea, vomiting, fatigue, and jaundice. Case 2 involved a 20-year-old Thai female with cough and chest pain, confirmed pulmonary tuberculosis in the right lung, who developed abnormal liver function and skin rash after 13 days of treatment. Both cases were diagnosed as pulmonary tuberculosis with drug-induced hepatitis. Their treatment regimens were adjusted to a 9-month course, and close monitoring was provided throughout care. The comparison highlights that drug-induced hepatitis can occur in the early phase of tuberculosis treatment. Regular monitoring of adverse drug reactions, liver function tests, and timely adjustment of treatment regimens are essential for patient safety and continuity of care. Moreover, the application of Orem’s theory facilitated the identification of self-care deficits, individualized nursing care planning, and patient engagement in their own health management. These findings provide practical implications for nursing practice to enhance tuberculosis control, reduce complications, and improve the quality of care within healthcare systems.