Page 1594 - Saunders Comprehensive Review For NCLEX-RN

the diagnosis.
3. After medications are started, sputum samples are
obtained again to determine the effectiveness of
therapy.
4. Most clients have negative cultures after 3 months of
treatment.

J. Tuberculin skin test (TST) (Table 50-1)

1. A positive reaction does not mean that active disease
is present but indicates previous exposure to
tuberculosis or the presence of inactive (dormant)
disease.
2. Once the test result is positive, it will be positive in
any future tests.
3. Skin test interpretation depends on 2 factors:
measurement in millimeters of the induration and the
person’s risk of being infected with tuberculosis and
progression to disease if infected.
4. Once an individual’s skin test is positive, a chest x-ray
is necessary to rule out active tuberculosis or to detect
old healed lesions.

K. The hospitalized client

1. The client with active tuberculosis is placed under
airborne isolation precautions in a negative-pressure
room; to maintain negative pressure, the door of the
room must be tightly closed.
2. The room should have at least 6 exchanges of fresh air
per hour and should be ventilated to the outside
environment, if possible.
3. The nurse wears a particulate respirator (a special
individually fitted mask) when caring for the client
and a gown when the possibility of clothing
contamination exists.
4. Thorough hand washing is required before and after
caring for the client.
5. If the client needs to leave the room for a test or
procedure, the client is required to wear a surgical
mask.
6. Respiratory isolation is discontinued when the client is
no longer considered infectious.
7. After the infected individual has received tuberculosis
medication for 2 to 3 weeks, the risk of transmission is
reduced greatly.

L. Client education (Box 50-10)

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