Tuberculosis Nursing Care for the NCLEX

TB Screening

• Mantoux (TST/PPD): Read in 48-72 hours. Measure induration (not redness)
• Positive: ≥5mm (immunocompromised, close contacts), ≥10mm (high-risk groups), ≥15mm (low-risk)
• QuantiFERON Gold: Blood test, single visit, not affected by BCG vaccine
• Positive test = exposure, NOT active disease. Need chest X-ray to determine active vs latent

Active TB

• Night sweats, weight loss, productive cough, hemoptysis, fatigue
• Confirmed by: sputum acid-fast bacilli (AFB) smear and culture
• 3 negative sputum cultures needed to discontinue isolation

Isolation

• Airborne precautions: N95 respirator, negative pressure room
• Door must remain closed
• Client wears surgical mask during transport

RIPE Therapy (6-9 months)

• Rifampin: turns body fluids orange-red (expected)
• Isoniazid (INH): monitor for hepatotoxicity, take with vitamin B6
• Pyrazinamide: monitor liver function
• Ethambutol: monitor for visual changes

Study at Respiratory Disorders cheat sheet and Infection Control deep dive.