TUBERCULOSIS ASSESSMENT FOR PATIENTS AND HEALTHCARE PROFESSIONALS. (NURSING -BASED ON MY CLINICAL EXPERIENCES)

What is a Tuberculosis test?.TB test is done by injection of small amount of fluid known as tuberculin(PPD) into the lower part of the arm in the skin using a tuberculin syringe. ( You should document it in patient medical records.That is the evidence to show that it was done. I usually will mark and document it in the patient chart and in the copy that I will give to the patient to take home. And I will tell the patient to return in 48hours to 72hours for it to be read by healthcare professionals. This is the most common way that the doctor will diagnose tuberculosis.

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All patients should be assessed for history of Tuberculosis. The diagnosis of TB(Mantoux test- Diagnostic tests are combination of assessment with TB skin test or Quaniferon Gold with the sputum smear to test for AFB culture.(AFB sputum is collected very early in the morning before breakfast)There is a special containerfor it. Chest xray is also done .There are pulmonary TB,and some wounds might be positive for TB.

The questions starts like this. (Please note that there are TB SCREENING Forms). Have you had any symptoms of Tuberculosis such as :

1.Coughing that is productive cough.

2.Weakness or fatigue.

3.Hemoptysis.

4.Fever,chills.

5.Night sweats.

6.Loss of appetite.

7.Unexplained weight loss.

Have you recently traveled out of the country? .(Countries with high exposure to TB)Patients suspicious or positive for Tuberculosis are placed in a NEGATIVE PRESSURE ROOM WITH ANTEROOM ROOM.( N95 masks ,gown,and gloves for healthcare professionals, and patient’s families to wear surgical masks)People with Latent TB do not feel sick,no symptoms and cannot spread TB.”DO NOT STAY TOO LONG IN TB ROOM” .

Have you been recently exposed to TB?.

TUBERCULOSIS TEST FOR HEALTHCARE PROFESSIONALS PER. CDC RECOMMENDED GUIDELINES.

Before you are hired as a healthcare professionals, you must be tested for TUBERCULOSIS Skin test known as PPD(Purified protein derivative)is performed. And read after 48hours but before 72hours and the Quaniferon gold test(blood test) Some healthcare professionals from some other countries received BCG when they were young so their PPD will often be positive, so Chest Xray will be required to show that you don’t have Tuberculosis. If induration is 15mm or greater means the person is positive for TB. Positive TB shows that TB bacteria has been detected. It doesn’t mean that there is latent TB or active TB.

These healthcare professionals are tested for. TB.

Inpatient healthcare workers.

Outpatient healthcare workers.

Emergency room healthcare staff.

Laboratories staff.

Correction staff.

Homeless shelters and clinics.

Long term care healthcare workers. Etc.

In May 17th 2019 the CDC and NATIONAL TB controllers Association updated their recommendations. Please follow your facility policy and procedures. (INFECTION DISEASE DOCTORS follow up with tuberculosis patients. When the patient is cleared from TB,it must be reported to public health before patient is discharged to the public.

QUESTIONS:

1. What is TB?.
2. How does it spread?.
3. What is TB disease?.
4. What is latent TB?
5. NB : There are treatment for TB.( The doctor orders the tuberculosis medications such as Isoniazid (INH),Rifampin(RIF)ethambutol(EMD)pyrazinamide(PZA)
6. California Education code seaction 49406 and 8708.6 and California Health and Safety code,sections 1597.055,121525,121555.

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