A client diagnosed with active tuberculosis is in a negative pressure room for respiratory airborne isolation. How long should the nurse maintain the client in this type of isolation?

Question

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 client has orders for discharge
4. Until the chest x-ray is normal

Answer 1

Until three consecutive sputum specimens for acid fast bacilli are negative

Rationale: The client should remain in isolation until three consecutive sputum cultures have tested negative. Until that time and in spite of treatment, there is no certainty that the client is not infectious. 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. The chest x-ray validates the amount of lung involvement; the client may experience chronic changes, such as nodules. The client should not be discharged without evidence that he or she is no longer infectious.