A nurse on a medicalsurgical unit is caring for a newly admitted client with a diagnosis of R/O tuberculosis.

Exhibits

Which of the following findings should the nurse report to the provider?

A. Yellow sclera: This may indicate hepatotoxicity, a serious adverse effect of isoniazid and rifampin. The provider should be notified immediately to assess liver function and adjust medications if necessary.
B. Increasing AST level: The AST increased from 35 to 36 units/L, which is within the normal range but may suggest early signs of liver dysfunction, especially in combination with other findings like jaundice.
C. Weight loss: While weight loss is a symptom of tuberculosis (TB), the client reported a 3.2 kg (7 lb) loss before admission. Since this is an expected finding with TB, it does not necessarily require immediate provider notification unless it continues despite treatment.
D. Mantoux test result: A 12 mm induration is considered positive in highrisk populations but does not confirm active TB. Given that the client already has a chest Xray showing caseation, a positive skin test is not the most critical finding to report.
E. Increasing ALT level: The ALT increased from 36 to 38 SI/L, which is a slight rise but, along with the AST increase and jaundice, suggests possible liver dysfunction due to TB medications.
F. Reddishorange urine color: This is a normal side effect of rifampin and does not indicate harm. It does not require provider notification.

A. A room with air exhaust directly to the outdoor environment. Clients with active tuberculosis (TB) require airborne precautions, which include placement in a negativepressure room with air exhaust directed outside to prevent the spread of infectious particles. This setup ensures that contaminated air does not circulate into other areas of the hospital.
B. A room in the ICU. The ICU is not an appropriate placement unless the client has severe respiratory distress or critical complications. TB patients should be isolated in a dedicated airborne infection isolation room (AIIR) rather than in an ICU, where other critically ill patients are at risk of exposure.
C. A room that is within view of the nurses' station. Proximity to the nurses' station is not a priority for TB management. Infection control measures, including negativepressure ventilation and airborne isolation, are far more important in reducing transmission risk.
D. A room with another nonsurgical client. TB is highly contagious, and placing the client in a shared room violates infection control protocols. Clients with active TB must be in a private, negativepressure room to prevent airborne transmission to others.