Question

You are a public health nurse working at a county immunization and tuberculosis (TB) clinic. B.A. is a 51-year-old woman who wishes to obtain a food handler's license and 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. What is TB, and what microorganism causes it?

2. What is the route of transmission for TB?

3. What PPE is needed to care for a client with TB?

4. What type of isolation precautions will the client be placed in?

5. 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.  

6. Describe the two methods of TB screening.

7. If B.A. has a red, non-swollen reaction is her screen positive or negative? Explain your answer.

8. If B.A. has a positive reaction does she have TB? What would she need to have done next?

Answer 1

Q1:

Answer: TB or tuberculosis is an infectious bacterial disease that mainly affects the lungs. The disease is caused by bacteria called mycobacterium tuberculosis.

Q2:

Answer: The TB infection is contagious. It can be transmitted from one person to another person through droplets during coughing, sneezing, speaking by the patient. The bacteria is carrying in the airborne particles.

Q 3

Answer: PPE is needed for caring for a patient with active Tb. It is because the infection is contagious as it transmitted from one person to another person through droplets produced by the patient during coughing, sneezing, speaking. If the caregiver inhaled the infected air then there is a chance to transmit. That is the reason for the use of PPE while taking care of the patient.

Q 4

Answer: The patient should be kept in the isolation room where there should be limited visitors, use of proper PPE, and hygiene for the caregiver. This will helps to reduce the transmission of infection from one person to another person.

Q 5

Answer: The more low immunity the more risk of getting the TB infection. The risk group includes HIV/ AIDs patients, cancer patients, old age people, children, people who are in contact with the infected person repeatedly.

Q 6

Answer: The two methods of screening for TB are TB skin tests or the Monteux test and TB blood test. In TB skin test PPD tuberculin is injected intradermal and check for the reaction. In the TB blood test, blood is drawn and check for the present for the bacteria in the blood. The best and commonly used is the Monteux test.

Q 7

Answer: For BA if there is red and swollen in the injected part in the skin it does not mean that he is positive. There is a need to check the size of the swollen is 10 mm or more. If the size is more than 10 mm then it is considered as positive. But for the HIV patient, if the size in more than 5 mm it is considered to be positive.

Q 8

Answer: If the person having a positive reaction for the skin test then the person is infected with tuberculosis. The next she have to do is start taking the tuberculosis treatment and isolation form others to prevent the infection.