Stage 4 — Generate solutions. Select ALL actions appropriate during the first hour after suspected infectious pulmonary TB is recognized.
Select All That Apply
Choose your responses, then check the answer.
Explanation
Appropriate actions: 1, 3, 5, and 6 Client masking, a closed private room pending AIIR placement, limited transport, fit-tested respirator use, complete respiratory sampling, and coordinated risk-based exposure assessment address source, environment, worker protection, diagnosis, and public health. A negative IGRA does not exclude active TB in a symptomatic client. Contact investigation does not label every person in the building identically or begin preventive medication without individual evaluation and TB-program guidance.
Containment Mask the client and close the door immediately. Use an AIIR as soon as possible and fit-tested N95 or higher respiratory protection for personnel entering.
Diagnosis Collect the recommended sputum series and use NAA on at least one respiratory specimen when it affects management. Culture and susceptibility testing remain necessary.
Exposure response Infection prevention and the TB program define and prioritize contacts. The chemotherapy recipient and young child warrant rapid assessment because progression can be especially consequential.
Avoid two shortcuts An IGRA tests immune sensitization and cannot alone rule out active pulmonary disease. Exposure management is individualized rather than automatic treatment of an entire building.
Scenario (Stage 4 — Generate solutions)The client is masked and an AIIR is being prepared. The charge nurse coordinates containment, testing, and the first exposure-response steps.
Client mask during transport — Source control used when medically necessary movement outside the AIIR cannot be avoided.
AFB smear and culture — Smear helps estimate infectiousness rapidly, while culture is the microbiologic standard and enables organism confirmation and further testing.
Contact prioritization — Prompt evaluation of contacts with intense shared-air exposure or high risk of progression, followed by expansion according to investigation findings.