Risk factors for TB infection according

Case Study: Tuberculosis

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You are a public health nurse working at a county immunization and tuberculosis (TB) clinic. B.A. is a 51-year-old woman who wishes to obtain a food handler’s license and is required to show proof of a negative Monteux (purified protein derivative [PPD]) test result before being hired. She came to your clinic 2 days ago to undergo a PPD test for TB. She has returned to have you evaluate her reaction.

What is TB, and what microorganism causes it?

What is the route of transmission for TB?

The Centers for Disease Control and Prevention (CDC) recommends screening people at high risk for TB. List five populations at high risk for developing active disease.

Describe the two methods of TB screening.

How do you determine whether a Monteux test result is positive or negative?

What additional information do you need to obtain from B.A.?

You inform B.A. of the test result. She asks you what the result means. How will you respond?

Case Study Progress:

B.A. is a natural-born American and has no risk factors for TB infection according to the CDC guidelines. She has a 6-year history of type II diabetes mellitus that is well controlled with metformin (Glucophage). She admits that her mother had TB when she was a child but says she herself has never tested positive before. She is angry at the proposition that she might have TB and says, “I feel just fine and I don’t think anything else is necessary.”

What steps need to be done to determine whether B.A. has an active TB infection?

What instructions would you give this patient upon discharge from the hospital?