A client with HIV infection has a history of close exposure to someone with active pulmonary tuberculosis and has developed a cough and low-grade fever
The client's Mantoux is negative but the client has been admitted to the hospital for further testing. The most appropriate action by the nurse is to (Select all that apply) a. admit the client to a private room.
b. anticipate orders for AFB testing.
c. place the client in respiratory isolation.
d. screen potential roommates carefully.
e. select a room close to the nurses' station.
B, C
The client should understand that a negative test result does not always mean that TB is absent, particularly in HIV-positive clients, who are immunosuppressed. Until TB has been ruled out, the client needs to be in respiratory isolation in a negative airflow room. These rooms should send room air directly to the outside and have at least six air exchanges per hour. Putting the client in a private room is not enough. The client should not have a roommate. The location of the room is less important than having negative airflow capability. Definitive testing for tuberculosis includes chest x-ray, AFB smears from sputum, and culture.
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