Comprehensive nursing care for a pregnant adolescent with extrapulmonary tuberculosis and hiv: a case study

Abstract

Introduction: HIV coinfection and extrapulmonary tuberculosis during adolescent pregnancy require coordinated clinical, educational, and psychosocial care. Objective: To analyze comprehensive nursing care through the Nursing Process and the Tidal Model. Methods: A descriptive case report with retrospective review of clinical records and prospective maternal-neonatal follow-up, structured according to the CARE guideline. Results: A 17-year-old pregnant patient had an initial viral load of 13,604 copies/mL and a CD4 T-lymphocyte count of 140 cells/µL. A positive urinary lipoarabinomannan result bacteriologically confirmed TB; SINFOTB classified it as extrapulmonary, without anatomical confirmation of renal involvement. Xpert MTB/RIF Ultra and sputum culture results were negative. She received 2HRZE/4HR antituberculosis treatment and antiretroviral therapy with tenofovir, lamivudine, and dolutegravir. Nursing care prioritized risk of postoperative infection, inadequate health knowledge, and readiness for enhanced self-management; interventions included surveillance, education, verification of learning, and three home visits. The Tidal Model guided narrative listening, recognition of strengths, agreed goals, and autonomy. The mother completed 150 antituberculosis doses and maintained viral suppression. The newborn, classified as having high-risk perinatal HIV exposure, received exclusive formula feeding and antiretroviral prophylaxis; four HIV-1 RNA tests yielded undetectable results during the study period. Conclusion: The Nursing Process enabled the organization and documentation of interventions, while the Tidal Model was used as a framework for integrating person-centered clinical and psychosocial care.