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All Journal Jurnal Keperawatan Priority Sanitas: Journal of Health, Medical, and Psychological Studie
Robin Ferdiansyah Sitopu
Universitas Prima Indonesia
Dentistry Health Professions Medicine & Pharmacology Nursing Public Health

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Nursing Care for XDR-TB Complicated by Infected Bronchiectasis and Malnutrition: A Case Report Robin Ferdiansyah Sitopu; Afeus Halawa; Basri Basri; Murni Aritonang; Fitriyana Br Kaban
Jurnal Keperawatan Priority Vol. 9 No. 1 (2026)
Publisher : Universitas Prima Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.34012/jukep.v9i1.7886

Abstract

Extensively drug-resistant tuberculosis (XDR-TB) presents a formidable challenge, often exacerbated by irreversible structural lung damage and severe malnutrition. Roy’s Adaptation Model (RAM) was employed as the theoretical framework to address the profound physiological and psychosocial disruptions in a high-complexity case. This report describes the integrated, nurse-led management of a patient with XDR-TB and destroyed lung syndrome during the acute stabilization phase. A 39-year-old woman with a decade-long history of TB treatment failure was admitted to a national referral hospital with XDR-TB, profound cachexia (BMI 13.96 kg/m2), and severe hypercapnia (pCO2 94.7 mmHg). During a 72-hour acute stabilization period, integrated nursing-led interventions including the Active Cycle of Breathing Technique (ACBT), therapeutic positioning, and a high-calorie, high-protein regimen resulted in marked clinical improvement. Respiratory stabilization allowed for oxygen weaning from 5 to 4 L/min with an SpO2 increase to 97%. Breaking the catabolic cycle was evidenced by weight stabilization (maintained at 35 kg) and a positive metabolic shift, alongside significantly improved oral intake (80–90% of requirements).. Functional status progressed from total bed rest to independent short-distance ambulation without desaturation. Comprehensive nursing interventions, focusing on airway clearance and acute metabolic stabilization, play a pivotal role in the rapid stabilization of complex XDR-TB cases. Highlighting outcomes within the first 72 hours demonstrates that structured nursing care acts as a catalyst for physiological adaptation, even in the presence of severe anatomical lung destruction.
Analisis Asuhan Keperawatan pada Pasien Tuberkulosis Paru: Studi Kasus Gangguan Sistem Respirasi di Rumah Sakit Umum Royal Prima Medan Yesa Meliana Marbun; Ramadhani Ramadhani; Yohana Notris Telaumbanua; Meiman Harapan Nduru; Robin Ferdiansyah Sitopu
Journal of Health, Medical, and Psychological Studies Vol 2 No 1 (2026): : August: Sanitas: Journal of Health, Medical, and Psychological Studies
Publisher : CV SCRIPTA INTELEKTUAL MANDIRI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.65310/bp9nnj20

Abstract

Tuberculosis (TB) is an infectious disease caused by the bacterium Mycobacterium tuberculosis, which primarily affects the lungs. The bacteria can also affect other organs, such as the lymph nodes, skin, digestive tract, meninges, and others. Tuberculosis is transmitted through the air. Most people who are infected do not show symptoms, as the bacteria can remain dormant in the body and become active when the immune system is compromised. The primary symptoms of pulmonary TB are a persistent cough and the production of sputum. The objective of this study is to determine the nursing care for pulmonary tuberculosis provided to Mr. R at Royal Prima Hospital in Medan. This nursing care study employs a descriptive case study research method. This is a study focused on a comprehensive, in-depth exploration of nursing care issues for a single individual, from assessment through evaluation. The assessment revealed complaints of coughing up blood for 2 days and a productive cough for 2 weeks, audible rales, weight loss, confusion, and a lack of knowledge regarding his condition. The nursing diagnoses identified were ineffective airway clearance, nutritional deficit, and knowledge deficit. The interventions implemented included airway management, bleeding prevention, nutritional management, and health education. The evaluation was conducted after the nursing interventions were implemented, resulting in the issues being fully resolved.  
Co-Authors Afeus Halawa Basri Basri Fitriyana Br Kaban Meiman Harapan Nduru Murni Aritonang Ramadhani Ramadhani Yesa Meliana Marbun Yohana Notris Telaumbanua