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Carlos Mancia Room. Case Study.

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Carlos Mancia , 48-year-old male, Spanish speaking migrant worker recently hospitalized for active tuberculosis. Carlos presented with symptoms of blood-tinged mucous and a productive cough. His wife ... , Maria exhibited symptoms of active tuberculosis, a productive cough and night sweats. Carlos initially resisted referral for treatment from the public health department because he was fearful of being discovered as an undocumented migrant worker. The community health nurse met with Carlos and his wife and the nurse shared that tuberculosis is a reportable illness and must be reported to the public health department using Centers of Disease Control Guidelines. Carlos met with the public health department and home health visits were scheduled for directly-observed therapy (DOT) for medication administration. The community health nurse tells Carlos and Maria about the option for video observation of medications. Carlos and Maria are educated about their medications which must be given together at the same time each day. Medications: NKDA Isoniazid (INH) 300 mg daily orally for 30 days Rifampin (RIF) 600 mg daily orally for 30 days Pyrazinamide (PZA) 2000 mg four times daily orally (max 2 gm/day) by mouth for 30 days Ethambutol (EMB) 1600 mg daily orally for 30 days Pyridoxine 50 mg daily orally for 30 days Social history: Carlos does not speak English. He lives in a three-bedroom, multigenerational home with his wife, her mother, and Carlos and Maria’s three children, ages 22, 19 and 17, and 3-year-old granddaughter. Carlos’s electronic health record states that he is “a form of Catholic” and that he is “devoted to his religious practices.” Carlos works for a roofing company and works long hours. Maria and their two oldest daughters, Teresa (22-year-old) and Maria Elena (19-year-old) clean houses. Their 17-year-old son, Alejandro is a senior in high school and plays competitive soccer. Maria’s mother, Margarita, maintains the home and prepares most of the meals. Margarita plays bunko at the senior center twice a week. Teresa’s daughter, Josephine, goes to a day care center three days a week. [Show More]

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