The 95-year-old nursing home client has a productive cough and night sweats. When she is tested for tuberculosis with a PPD, the injection site does not have a skin response of indura-tion by 48 hours after the injection
What is the correct interpretation of this finding? A. The test is negative and airborne precautions are not necessary because the client does not have tuberculosis.
B. The test is negative; however, airborne precautions are still necessary until other test results for tuberculosis are also negative.
C. The test is negative and airborne precautions are still necessary because the client probably has a bacterial pneumonia.
D. The test is negative and airborne precautions are not necessary because the client has sufficient antibodies against the tuberculosis bacillus.
B
The PPD test for tuberculosis relies on a cell-mediated immune response in the skin to react with the tuberculosis protein for a positive result. Adults who are very old may not have enough of a cell-mediated immune response to demonstrate a positive reaction to a PPD, a condition called anergy. Airborne precautions are needed when clinical manifestations of tuberculosis are present and the results of more definitive testing are unknown or such testing has not yet been per-formed.
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