A patient diagnosed with active tuberculosis is in a negative pressure room for respiratory airborne isolation. How long should the nurse maintain the patient in this type of isolation?
1. Until three consecutive sputum specimens for acid fast bacilli are negative
2. Until the Mantoux test (PPD) converts from positive to negative
3. Until the patient has orders for discharge
4. Until the chest X-ray is normal
1
Rationale 1: Until three consecutive sputum cultures have tested negative, even with treatment, there is no certainty that the patient is not infectious.
Rationale 2: A positive PPD indicates that an individual has been exposed to tuberculosis and has developed antibodies, so the PPD will not convert back to negative.
Rationale 3: Discharge does not indicate the patient is no longer infectious. Many patients with TB are managed at home. Patients are isolated in the hospital environment because of the number of immunocompromised patients also in the hospital.
Rationale 4: The chest X-ray validates the extent of lung involvement; the patient may experience chronic changes, such as nodules.
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