Wrench in the works - TB test

  1. Hello all. I'm a pre-nursing student, and I was intending to take a CNA course next semester to gain some experience. It required a two-part TB test. The first part was barely negative, and the second (read today), was inequicovably positive.

    I was told that I'll need to have a chest x-ray done (next Thurs.), and that I should never again have a Mantoux test done, because it will always be positive.

    If the CXR is positive, I know that I'll have to take antibiotics for a while. That doesn't bother me. What I need to know is how this will affect my career plans. Will having a positive skin test, let alone a positive CXR, have a serious adverse effect on getting accepted to any RN programmes, or being hired in any kind of health care?

    I'm about at the point where I don't know whether to laugh or screech. :stone
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  2. 14 Comments

  3. by   MajorDomo
    The positive TB skin test means that you might have been exposed to TB at some time. It is just a sceening test that has some false positives.
    The CXR will show if you have TB signs in your lung fields, can't recall the medical term right now. If that is positive, then you will give a sputum sample and start on, depending in which state, directly observed therapy (DOT) antibiotics. The only impeadment on hiring is if the sputum is positive, then you would be required to be on the antibiotics for awhile, prior to hiring.
    If the CXR is negative, then in most places you get a repeat cxr every five years.
    As for your future career prospects, it should not hinder them in the slightest, just remember to make copies of all your documents in case the place you want to work asks for them.
    Hope this helps
    MajorDomo
  4. by   SFCardiacRN
    It is true that you can no longer have the skin test. Don't assume the x-ray will be positive. It might not. In California, you will need an annual chest x-ray to work in the medical field. The employer hospital will pick up the cost.
  5. by   suzanne4
    It should not hinder anything, but you will need a chest x-ray yearly if you are working in a healthcare facility. This is a federal requirement, not a state one. This will meet the requirement, same as if you were getting the Mantoux yearly. Not a big deal to prevent you from doing anything at all.
  6. by   MIA-RN1
    Quote from SaraO'Hara
    Hello all. I'm a pre-nursing student, and I was intending to take a CNA course next semester to gain some experience. It required a two-part TB test. The first part was barely negative, and the second (read today), was inequicovably positive.

    I was told that I'll need to have a chest x-ray done (next Thurs.), and that I should never again have a Mantoux test done, because it will always be positive.

    If the CXR is positive, I know that I'll have to take antibiotics for a while. That doesn't bother me. What I need to know is how this will affect my career plans. Will having a positive skin test, let alone a positive CXR, have a serious adverse effect on getting accepted to any RN programmes, or being hired in any kind of health care?

    I'm about at the point where I don't know whether to laugh or screech. :stone
    It won't affect you AT ALL having a positive ppd. If your cxr is negative they will still likely put you on INH. Happened to me. SOmewhere along the road I must have been exposed but w/ the clean cxr I just took INH for a year and that was that.
    The biggest problem is always having to have documentation and everyone and his brother wanting me to get Xrays.
    If you are not actively sick (cough, fever, chills, weight loss, fatigue etc) then I am guessing you will have a negative Cxr and follow a course similar to mine.
    it is scary for sure but it is totally do-able.
  7. by   SaraO'Hara
    I've got a history ~3 years of some kind of ambiguous lung trouble (pain, SOB, occasional cough, fever), but never had it checked out due to age and insurance problems. I suppose I should mention this to the x-ray nurse?
  8. by   Nurse Ratched
    Quote from SaraO'Hara
    I've got a history ~3 years of some kind of ambiguous lung trouble (pain, SOB, occasional cough, fever), but never had it checked out due to age and insurance problems. I suppose I should mention this to the x-ray nurse?
    If there are old granulomata on your films, your history could be useful for the doctor, but it wouldn't change the usual recommended treatment of either 9 months INH or 4 months Rifampin - prophylatic treatment to kill any latent TB germs that could become active in the future (see the CDC website for details.) It will most assuredly not deter you in any way from your nursing career. My brother and I have been in health care about the same length of time - 17 years. He popped a positive test after his first year - I'm still negative despite working with high risk populations. Go figure.

    As long as you're not CURRENTLY having bloody cough, night sweats, weight loss, I wouldn't get frothy about it .
  9. by   NurseLatteDNP
    I don't know if you were born in the US, but in many other countries, the babies get the BCG shot when they are born. That will make you have a positive test for the rest of your life, according to my doctor. We figured that out after I was wondering how come my test was positive without any exposure. My chest x ray was negative. I was born in Croatia and all of us got that shot when we were born. Good Luck to you.
  10. by   following_faith
    I just want to wish you luck! I am glad to read on here that you're career will not be deterred in any way! Keep us posted and take care!
  11. by   KatieBell
    No problems there, just be sure to keep a copy of your chest xray with you, don't let the hospital just hold it. Thus if you change jobs/school etc, you can always present it immediately. I know thats odd, but it has saved me many days of waiting for a copy to be forwarded to some place. I have a negative TB test, but needed the CXR as confirmation because of my past work on a large TB project...
  12. by   MMARN
    Maybe a stupid question, but I would like to know. How do you prevent yourself from being exposed to ppd or to just not getting it period?
  13. by   SaraO'Hara
    kiyatylese: I was born in Germany, but on an American military base. I've never had a BCG vaccine, and had negative TB tests upon re-assignment to Fort Hood, TX, in 1991 (I would have been 3), and again in 1993.

    Nurse Ratched: Hehe, "frothy!" I'm not getting frothy, just minorly spastic

    Mave: PPD refers to the material injected subcutaneously in the test. I think you mean TB?

    Thanks to the rest of you for advice, comfort, and tips. I'll sleep better tonight
  14. by   Jessy_RN
    I tested positive a year and a half ago. I felt like you are feeling now. I had a chest x-ray that came back negative. My NP encouraged me to follow a 9 month Isoniazid treatment (versus 6 mth). I must have yearly chest x-rays and can NEVER have a skin test performed again. You will get documentation that you need to have to prove it. My nursing school has it on file along with yearly x-ray proof. Best wishes to you and don't worry.

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