Tuberculosis: NCLEX Priorities
TB: airborne precautions, PPD/IGRA, RIPE treatment, latent vs active.
TB is airborne. NCLEX tests precautions, screening, and the 4-drug regimen.
Airborne precautions
Negative-pressure room. N95 mask for staff. Patient wears surgical mask outside room. Limit transport.
Screening
PPD (Mantoux): read 48-72h. ≥5 mm in immunocompromised/contacts/HIV. ≥10 mm in higher-risk. ≥15 mm in low-risk. IGRA (QuantiFERON, T-SPOT), blood test, no return visit.
Latent vs active
Latent: positive screen, negative CXR, no symptoms, not contagious. Active: positive sputum AFB, symptoms (cough >3 weeks, night sweats, weight loss, hemoptysis).
Treatment
Latent: INH 9 months, or rifampin 4 months, or INH+rifapentine weekly × 12. Active: RIPE × 2 months, then INH+rifampin × 4 months.
Adherence
DOT (directly observed therapy) for active TB. Non-adherence drives resistance.
Frequently asked
BCG vaccine and PPD?
BCG can cause false-positive PPD. Use IGRA instead.
When discontinue isolation?
Improvement + 3 consecutive negative sputum AFBs typically.
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