Never enter the room of an active TB patient without a fit-tested N95 respirator.
Before you read
Test yourself first: 5 questions
Question 1 of 5
A client with active tuberculosis is being discharged home. The nurse teaches the family that:
Answer: B. Teach adherence to the full multi-drug regimen for months, cover coughs, ensure ventilation, and that the client becomes much less infectious after consistent treatment; sputum cultures guide when precautions can ease. Stopping medication early causes resistance and relapse.
Question 2 of 5
A home health nurse is caring for a client with active pulmonary tuberculosis in the home. Which precaution is MOST important to teach the family?
Answer: B. Tuberculosis spreads by airborne droplet nuclei, so adequate ventilation and having the client cover the mouth when coughing reduce transmission. The client should remain home and away from crowds until cleared, but opening windows for ventilation directly addresses airborne spread. TB is not spread by sharing dishes or by casual surface contact.
Question 3 of 5
A client is admitted with suspected pulmonary tuberculosis. Which type of isolation precaution should the nurse implement?
Answer: B. Tuberculosis is spread by droplet nuclei that remain suspended in air, so airborne precautions are required: a negative-pressure (AIIR) room and a fit-tested N95 respirator. Droplet precautions (surgical mask) are inadequate. Contact precautions address direct/indirect surface transmission. Standard precautions alone are insufficient for an airborne pathogen.
Question 4 of 5
A client is admitted with suspected tuberculosis. Which precautions does the nurse implement?
Answer: B. TB requires AIRBORNE precautions: a negative-pressure (AIIR) room and an N95 respirator. A surgical mask and standard room are inadequate.
Question 5 of 5
A client diagnosed with active tuberculosis has been on the standard medication regimen for treatment. Which criterion indicates the client is no longer considered infectious and airborne precautions may be discontinued?
Answer: A. A client with pulmonary TB is generally considered non-infectious after receiving effective therapy, showing clinical improvement, and having three consecutive negative acid-fast bacilli (AFB) sputum smears collected on different days. A single negative chest x-ray, being afebrile for one day, or completing only two days of medication does not establish non-infectiousness.
Keep the streak going with more questions like these, each with a full rationale.
What is tuberculosis precautions?
Active pulmonary TB requires airborne precautions because the bacteria stay suspended in air. Latent TB is non-infectious and asymptomatic but can reactivate. Treatment is long-term multidrug therapy, and strict adherence is essential to cure and to prevent drug resistance.
Key points to remember
- Classic symptoms are a chronic productive cough lasting over three weeks, hemoptysis, night sweats, low-grade fever, fatigue, and weight loss.
- TB spreads by airborne droplet nuclei, so active cases need a negative-pressure room and N95 respirators for staff.
- A positive PPD/Mantoux or IGRA shows exposure; a chest x-ray and sputum AFB cultures confirm active disease.
- Standard therapy is months of combined drugs, classically Rifampin, Isoniazid, Pyrazinamide, and Ethambutol (RIPE).
- The patient is considered noninfectious after adequate treatment yields three consecutive negative sputum AFB smears.
- Rifampin turns body fluids (urine, sweat, tears) orange-red, and isoniazid can cause peripheral neuropathy and hepatotoxicity.
Signs & symptoms
- Night sweats, hemoptysis, wt loss
- Chronic cough, low-grade fever
Nursing priorities
- Place the patient in a negative-pressure (airborne isolation) room and keep the door closed.
- Wear a fit-tested N95 respirator before entering; have the patient wear a surgical mask when transported.
- Administer multidrug therapy on schedule and use directly observed therapy (DOT) to ensure adherence.
- Collect sputum specimens for AFB smear and culture as ordered to track infectiousness.
- Monitor liver function and give vitamin B6 (pyridoxine) with isoniazid to prevent neuropathy.
Labs & values
Patient teaching
- Take all TB medications exactly as prescribed for the full course (months) even after feeling well, to cure infection and prevent resistance.
- Cover the mouth when coughing, wear a mask in public until cleared, and ensure household contacts get tested.
- Expect rifampin to turn urine and tears orange, avoid alcohol due to liver risk, and keep all sputum and clinic follow-ups.
Red flags: report now
- Never enter the room of an active TB patient without a fit-tested N95 respirator.
- Jaundice, dark urine, right-upper-quadrant pain, or rising liver enzymes signal drug hepatotoxicity and must be reported.
- Hemoptysis with respiratory distress requires urgent evaluation.
- Nonadherence to therapy must be addressed immediately because it breeds multidrug-resistant TB.
References
Clinical references for this topic
