In NCLEX world, patient was exposed to someone with TB

  1. Even when the question doesn't reveal results of the 3 diagnotic tests (ppd, chest xray, AFB), why do i still give prophylactic INH? Is it like a precaution?
    I assumed "exposure" meant "positive ppd, but negative chest xray." I shouldn't have done this to the question, but I'm filipino and I remembered when i came back from the Philippines my ppd was postive but my chest xray was negative, and my doctor didn't give me INH. That's why i chose the answer that said to do nothing.. another wrong move with nlcex questions lol. :P
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    About itsdebraanne

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    Graduate Nurse; from US
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  3. by   JustBeachyNurse
    Recent exposure to a known active TB+ patient is different that a random positive PPD with negative chest x-ray. Especially with individuals that are from areas with high exposure risk and possible BCG vaccination (BCG vaccination can wreck havoc with PPD testing), like when you returned from the Philippines. There is no way of knowing when you were possibly exposed to TB. Not the same as having a patient who was exposed at a known time to a patient with active infection....

    Now rethink your answer.

    If the question states that patient A was exposed to patient B (known active TB infection) what is the recommended course of action? The PPD test won't be useful after initial exposure as there was insufficient time for patient A to create antibodies to the exposure. So what is the correct response? Prophylactic treatment with INH (or whatever the current CDC/public health treatment recommendations are at the time)

    For a correlation, Students in classroom A were exposed to Patient B. Patient B was in school ill and then sent to ER where it was determined that patient B has active bacterial meningitis. What would be the course of action for the students exposed to Patient B? Prophylactic treatment.
  4. by   aprilpam77
    My case, PPD positive, Chest- Xray negative and my then doctor firmly recommended prophylactic treatment.