Question

You are a public health nurse working at a county immunization and tuberculosis (TB) clinic J. P. Is a 47-year-old woman who wishes to work as a Nursing Assistant in a local nursing home. She is required to show proof of a negative Mantoux (purified protein derivative [PPD]) test result before being hired. She came to your clinic 2 days ago to undergo a PPD test for TB. She has returned to have you evaluate her reaction.

1 Is J.P within the time frame for her PPD test to be evaluated? Please state the normal time frame.

What is the route of transmission for TB? What other infectious diseases are transmitted the same way?

What PPE is needed to care for a client with TB? Please include ALL the PPE required when caring for a client with TB.

When J.P. has her PPD test read by the nurse. The nurse states, the induration is 3mm, and non-palpable. Is this a positive or negative PPD test? Why?

What happens if J.P has a positive PPD test? What would be done next?

The Centers for Disease Control and Prevention (CDC) recommends screening people at high risk for TB. Name five groups of people that are at risk for developing active TB.  

J. P says since I will be exposed to more people because of my work if I get TB how long will I stay in the hospital. What is your reply? Include when a client can be discharged and any follow-up treatment.

Answer 1

1) No, J.P within the time frame for her PPD test has not be  evaluated as she came 2 days back for testing and the Mantoux (purified protein derivative [PPD]) usually takes 48 to 72 hoursafter the testing or injection . So, in just two days she has to get the actual result of the testing because there are higher chances that , tests get negative result in 48 hours but those results will change after 72 hours, so she will get better results on or after third day after testing .  The normal time frame for  Mantoux (purified protein derivative [PPD]) as in adults are significantly 72 hours after injecton . Probably , 48 to 72 hours are usually pressfered but 72 hours give reliable and acurate result of testing.

2) The  route of transmission for TB through air (aerosol) as it is spread by airborne transmission . It can not spread through surface contact . The transmission begins through air and then the droplet nuclei travels through the nasal passage , upper respiratory tract and reached alveoli through bronchi at the end . This is the whole route of transmission of TB. There are other  infectious diseases are transmitted the same way as TB transmit are the recent Covid 19 , wooping cough, the common cold and flu , chickenpox and measeals , mumps etc are the disease which transmit through air mainly and called airborne disease.

3) PPE means  personal protective equipment that is a respirator which is used as a high filtration mask , this help in preventing the the infectious nuclie droplets by the person who used to wear it .

PPE is used by Staff and they must wear a respirator.

PPE used when in contact with contagious patients either they are suspect or confirmed TB cases, when collecting sputum samples , when collecting and disposing of sputum containers . This also applicable to home-based DOT supervisors for taking care of the situation .

4)  J.P. has her PPD test read by the nurse in 48 hours according to given data.  The nurse states, the induration is 3mm, and non-palpable this will give a negative PPD test and this is beacuse the amount of induration shows localized swelling of skin and the test is conducted within 48 hours and than amount is also very low induration number and to get positive the induration amount should be more than 15 mm .

5)  

After J.P has a positive PPD test we will done next moved to the chest X rays and this help in identifying the difference of active TB disease and latent TB infection and further start curing it and start medication .