A nurse is obtaining a client's vital signs. Which of the following findings should the nurse report to the charge nurse?

Rationale for Correct Choices:

• N95 respirator. The client’s presentation of a cough, fatigue, night sweats, weight loss, and positive sputum culture for M. tuberculosis strongly suggests active tuberculosis (TB). Tuberculosis is transmitted through airborne particles, and an N95 respirator is required to protect healthcare workers from inhaling these particles. The N95 mask is specifically designed to filter out small particles, including the Mycobacterium tuberculosis bacteria.
• Gloves. Gloves should be worn when caring for patients with suspected or confirmed TB to prevent contact transmission. While TB is primarily transmitted via airborne particles, gloves are still necessary to protect healthcare workers from coming into contact with bodily fluids such as sputum or any other potentially contaminated materials.

Rationale for Incorrect Options:

• Face shield. A face shield is not required as primary protection for TB. While face shields can protect against splashes and droplets, TB is primarily transmitted via airborne particles, for which an N95 respirator is more appropriate.
• Surgical mask. A surgical mask is not sufficient for protecting healthcare workers against tuberculosis because it does not filter out small airborne particles like the N95 respirator does. Surgical masks are primarily intended for droplet precautions, but tuberculosis is spread through airborne transmission, necessitating an N95 mask for adequate protection.

• Gown. A gown is not required in this situation unless the patient has other symptoms or conditions that increase the risk of contamination, such as excessive wound drainage or the potential for body fluid splashes. For TB transmission, the primary concern is airborne transmission, and appropriate PPE focuses on respiratory protection (N95) and gloves for contact precautions.

A. "I should use my inhaler before exercising." Budesonide is an inhaled corticosteroid used for long-term asthma control, not for immediate prevention of exercise-induced bronchospasm. A short-acting beta-agonist (e.g., albuterol) should be used before exercise to prevent bronchospasm.
B. "I should use my inhaler when I have an asthma attack." Budesonide is not a rescue inhaler. It is used daily to reduce airway inflammation and prevent asthma exacerbations. During an acute asthma attack, a fast-acting bronchodilator, such as albuterol, should be used instead.
C. "I will rinse my mouth and gargle with water after each inhaler treatment." Rinsing the mouth after using an inhaled corticosteroid helps prevent oral candidiasis (thrush), a common side effect of steroid inhalers. This practice also reduces irritation and hoarseness associated with corticosteroid use.
D. "I will take my inhaler treatment before each meal and at bedtime." Budesonide is not taken on a strict schedule tied to meals or bedtime. It is usually administered once or twice daily, as prescribed, to maintain consistent anti-inflammatory effects.