Tuberculosis

Which discharge teaching should the nurse include in the teaching plan for a client who was treated for tuberculosis? Select all that apply. "Family members should have chest x-rays done." "Stop medication when coughing subsides." "Persons living with you should have skin testing." "Use your best judgment in terms of your daily medications." "Maintain adequate nutrition."

"Persons living with you should have skin testing." "Maintain adequate nutrition."

Which type of room should the William be placed in when transferred from the waiting room to an ED room? A client room with negative airflow capability. A multiple client room with curtains for privacy. A client room with contact precaution capability. A semi-private room with another client with respiratory symptoms.

A client room with negative airflow capability. Rationale: A client who presents with symptoms of TB should be placed in a client room with negative airflow capability as soon as possible. In this type of room, air circulates into the contaminated area of the client's room from surrounding areas. A multiple client room is not appropriate as the client with TB is contagious. The client suspected of having TB should never be placed in a room with other clients. All client rooms include contact precautions.

The nurse is providing care to William Parish, who presents in the emergency department with symptoms indicative of tuberculosis (TB). Which action should the nurse take when triaging William upon his arrival to the emergency department? Ask William to wear a gown while in the waiting area. Ask William to wear gloves until transferred to a room. Ask William to place a face mask over his mouth and nose. Ask William to use hand sanitizer after using the restroom.

Ask William to place a face mask over his mouth and nose. Rationale: Any client who presents with symptoms that are indicative of TB should be asked to wear a face mask until he or she is transferred to a room. TB is highly contagious and transferred via droplets in the air; therefore, placing a face mask on the client decreases the risk of transmission to others prior to placing the client in an appropriate room for airborne precautions.

The nurse is preparing to conduct the admission assessment now that William is settled into the room after transport. Which findings should the nurse anticipate when conducting the client's respiratory assessment? Select all that apply. Clear breath sounds Audible wheezing Eupnea (normal respiration) Rales (discontinuous crackle and pop sounds) Rhonchi (rattling sounds)

Audible wheezing Rales (discontinuous crackle and pop sounds) Rhonchi (rattling sounds) Rationale: When conducting a respiratory assessment for a client who is diagnosed with TB, you should anticipate audible wheezes, rales, and rhonchi. It is unlikely that the client's breath sounds are clear or that the client is experiencing eupnea, or normal respirations.

Which personal protective equipment (PPE) should the nurse don prior to entering the room to assist William after he has vomited? Select all that apply. Surgical mask N95 respirator Head covering Shoe protectors Gloves

N95 respirator Gloves Rationale: An N95 respiratory mask is required prior to entering any client's room who is suspected of having TB. Since the client has vomited, you should also wear gloves. A surgical mask, head covering, and shoe protectors are not required PPE.

Which instruction should the nurse provide to a client who has just received a PPD (purified protein derivative)? Return to the clinic in 48-72 hours to have the test read. Take antiviral medication as prescribed. Massage the subcutaneous injection site. There may be a very small amount of bleeding on the forearm.

Return to the clinic in 48-72 hours to have the test read.

Which type of precautions should be used when providing care for William? Select all that apply. Standard precautions Contact precautions Droplet precautions Airborne precautions Reverse isolation precautions

Standard precautions Airborne precautions Rationale: A client suspected of having TB will require standard precautions in addition to airborne precautions, a type of isolation precaution. Airborne precautions require placement in an airborne infection isolation room (AIIR) and the use of an N-95 mask.

The current plan of care includes discharge of William to home once the criteria to decrease the risk of disease transmission have been obtained. Which should the nurse assess to determine if he is likely to have successful adherence to treatment after discharge? Occupation Support system Financial resources Type of health insurance

Support system Rationale: In order to determine the client's successful adherence to the treatment plan after discharge, you should assess the client's support system. The client's occupation, financial resources, and type of health insurance are not factors that directly impact adherence to the treatment plan after discharge.

The nurse is caring for a client with a diagnosis of active tuberculosis. Which symptoms does the nurse expect this client to exhibit? Select all that apply. Fever Abdominal rigidity Abnormal breathing sounds Hypothermia Decreased oxygen saturation

Fever Abnormal breathing sounds Decreased oxygen saturation

Which nursing actions are appropriate when caring for a client diagnosed with tuberculosis? Select all that apply. Place on droplet precautions. Humidify oxygen when administered. Request dietary consult. Offer family members N95 masks. Medication teaching.

Humidify oxygen when administered. Request dietary consult. Medication teaching.

The nurse should include which priority preventive measure when teaching a group of adults about preventing the spread of tuberculosis? Handwashing Annual vaccination Isolation Covering mouth when coughing

Isolation

William is admitted to the medical-surgical unit. Which action is appropriate when transporting him from the ED to the unit? Wearing an N95 respirator during the transport Placing a surgical mask on the client for transport Asking the client to use the steps during transport Clearing all people from the route used for transport

Placing a surgical mask on the client for transport Rationale: If a client suspected of having TB must be transported from one area of the hospital to another, it is essential for you to place a surgical mask on the client for the transport. You would not wear an N95 respirator during the transport. It is inappropriate to ask the client to use the steps during the transport. Clearing all people from the route used for transport may not be feasible.

William's family arrives for a visit. Which personal protective equipment (PPE) should the nurse educate the family to wear? Gown Gloves Surgical mask Shoe protection

Surgical mask Rationale: A snug-fitting surgical mask is required for all visitors for a client who is isolated for potential TB. A gown, gloves, and shoe protection are not required PPE to enter this client's room.

What should the nurse recommend for the client's family members based on the current information? Annual chest x-rays Isolation precautions Tuberculosis skin tests Prophylactic antibiotics

Tuberculosis skin tests Rationale: It is important to stress the need for skin testing for all individuals who live with the infected person. Skin testing helps monitor the spread of TB and ensures that prompt treatment is initiated, if necessary. The family also needs to be notified that they'll need to return to have the skin test read in 48-72 hours. Annual chest x-rays are required for individuals who test positive for tuberculosis skin testing. Isolation precautions are not necessary unless a member of the family tests positive for TB. Prophylactic antibiotics are not initiated without knowing the client's TB status.