Abstract
Nursing care services for post-partum patients with medical diagnoses of Miliary Tuberculosis (TB) in the Adult Intensive Care Unit (ICU) require a comprehensive approach. Critical nursing care with ICU settings and the use of portable HEPA filter are employed as alternatives if the ICU does not have an isolation room. Therefore, ICU nurses must concern the patient's needs, both the socio-cultural and cultural bio psycho. Rehabilitating patients in isolation rooms or using a portable HEPA filter that makes the patient's situation isolated results in patients' uncomfortable and restless feeling. In this case, the treated patient hold Middle East culture, and thus, she concerns about covering her head as part of her religious and cultural teachings. However, wearing headgear or hijab is rarely considered in the ICU because ICU nurses prioritize the critical condition of patients as the most vital regard to consider. This case study describes how to provide care to patients in ICU with the use of portable HEPA filter as an alternative TB isolation room and a culturally sensitive approach to meet the socio-cultural needs of the patient. Therefore, she feels comfortable and safe in the ICU room.
 Keywords: Miliary TB, portable HEPA filter, cultural approach
Highlights
A good isolation room with negative pressure and HEPA filter system is recommended for the management of TB nursing rooms
Several nursing care problems that possibly emerge in patients with miliary TB are: 1) ineffective airway clearance associated with accumulation of secretions in the airway, 2) ineffective breathing patterns related to expansion and pulmonary recoil disorders, 3) disruption of gas exchange with alveolar-capillary membrane changes, 4) spontaneous ventilation disorders associated with metabolism disorder, 5) nutritional deficits related to anorexia, 6) hyperthermia associated with an inflammatory reaction to bacterial infections, 7) fatigue associated with metabolism disorders, and 8) anxiety-related to lack of knowledge of disease and medication mechanisms
Miliary TB is an illness caused by the wide dissemination of TB germs into several parts of the human body through lymph and blood circulation
Summary
For the last two decades, there is a significant change in the epidemiology of TB cases with the increase of migration, the involvement of HIV infection, and disease incidence at a younger age. The prevalence and the number of death caused by TB decrease [1]. The impact of this disease significantly reaches more than ten million cases, and one million ends, as recorded in 2015 [1]. Delayed diagnosis and initiation treatment are frequently caused by less recognition in several countries with low incidence. This becomes one of the main contributors of death caused by this disease [2]
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