Can you test positive for TB but not have it?
Persons with latent TB infection (LTBI) do not feel sick and do not have any symptoms, but usually have a positive reaction to the tuberculin skin test or TB blood test. They are infected with TB bacteria, but do not have TB disease. Persons with LTBI are not infectious and cannot spread TB infection to others.
Will latent TB show up on xray?
Image result for quantiferon gold positive but negative chest x-ray
Chest Radiograph
Lesions may appear anywhere in the lungs and may differ in size, shape, density, and cavitation. These abnormalities may suggest TB, but cannot be used to definitively diagnose TB.Apr 18, 2016
A person has latent TB infection if they have a positive TB skin test and a normal (negative) chest x-ray. This means the person has breathed in the TB germs, but his or her body has been able to fight the germs. People with latent TB infection do not feel sick and do not have signs of TB disease.
copy from https://www.cdc.gov/tb/topic/infectioncontrol/TBhealthCareSettings.htm
A tuberculosis (TB) infection control plan is part of a general infection control program designed to ensure the following:
In all health care settings, particularly those in which people are at high risk for exposure to TB, policies and procedures for TB control should be developed, reviewed periodically, and evaluated for effectiveness to determine the actions necessary to minimize the risk for transmission of TB.
The TB infection control program should be based on a three-level hierarchy of control measures and include:
On May 17, 2019, the Centers for Disease Control and Prevention (CDC) and the National Tuberculosis Controllers Association (NTCA) released updated recommendations on the frequency of TB screening, testing, and treatment for health care personnel. For guidance on facility risk assessments and infection control practices please continue to refer to the Guidelines for Preventing the Transmission of Mycobacterium tuberculosis in Health-Care Settings, 2005.
Administrative controls are the first and most important level of the hierarchy. These are management measures that are intended to reduce the risk or exposure to persons with infectious TB. These control measures consist of the following activities:
Many people born outside of the United States have been given a vaccine called BCG.
People who were previously vaccinated with BCG may receive a TB skin test to test for TB infection. Vaccination with BCG may cause a false positive reaction to a TB skin test.
A positive reaction to a TB skin test may be due to the BCG vaccine itself or due to infection with TB bacteria.
TB blood tests (IGRAs), unlike the TB skin test, are not affected by prior BCG vaccination and are not expected to give a false-positive result in people who have received BCG.
TB blood tests are the preferred method of TB testing for people who have received the BCG vaccine.
Why does BCG vaccine cause false-positive TB test?
Respiratory Syncytial Virus Infection (RSV)
reference and copy from : https://www.cdc.gov/rsv/about/symptoms.html
Respiratory syncytial (sin-SISH-uhl) virus, or RSV, is a common respiratory virus that usually causes mild, cold-like symptoms. Most people recover in a week or two, but RSV can be serious, especially for infants and older adults.
RSV is the most common cause of bronchiolitis (inflammation of the small airways in the lung) and pneumonia (infection of the lungs) in children younger than 1 year of age in the United States.
People infected with RSV usually show symptoms within 4 to 6 days after getting infected. Symptoms of RSV infection usually include
These symptoms usually appear in stages and not all at once. In very young infants with RSV, the only symptoms may be irritability, decreased activity, and breathing difficulties.
Almost all children will have had an RSV infection by their second birthday.
However, repeat infections may occur throughout life, and people of any age can be infected. Infections in healthy children and adults are generally less severe than among infants and older adults with certain medical conditions. People at highest risk for severe disease include
In the United States and other areas with similar climates, RSV circulation generally starts during fall and peaks in the winter. The timing and severity of RSV circulation in a given community can vary from year to year.
People infected with RSV are usually contagious for 3 to 8 days and may become contagious a day or two before they start showing signs of illness.
Call your healthcare professional if you or your child is having difficulty breathing, not drinking enough fluids, or experiencing worsening symptoms.
RSV can also cause more severe infections such as bronchiolitis, an inflammation of the small airways in the lung, and pneumonia, an infection of the lungs. It is the most common cause of bronchiolitis and pneumonia in children younger than 1 year of age.
Healthy adults and infants infected with RSV do not usually need to be hospitalized. But some people with RSV infection, especially older adults and infants younger than 6 months of age, may need to be hospitalized if they are having trouble breathing or are dehydrated.
In the most severe cases, a person may require additional oxygen, or IV fluids (if they can’t eat or drink enough), or intubation (have a breathing tube inserted through the mouth and down to the airway) with mechanical ventilation (a machine to help a person breathe). In most of these cases, hospitalization only lasts a few days.
Learn more about people at high risk for severe RSV infection.
There are steps you can take to help prevent the spread of RSV. Specifically, if you have cold-like symptoms you should
Methamphetamine is a potent central nervous system stimulant that is mainly used as a recreational drug and less commonly as a second-line treatment for attention deficit hyperactivity disorder and obesity.
What are the effects of meth on the nerve pathway?
Meth affects the central nervous system by flooding the brain with dopamine, the neurotransmitter responsible for feelings of pleasure and reward.
Because meth provides the brain with an artificial source of dopamine, it can cause the neurotransmitter to fire abnormally.Sep 16, 2021
What is meth used for medically?
Methamphetamine is used to treat attention-deficit hyperactivity disorder (ADHD). It belongs to the group of medicines called central nervous system (CNS) stimulants.
Sentence structure : she smoked meth
The Rapid Response Team — known by some as the Medical Emergency Team — is a team of clinicians who bring critical care expertise to the bedside. Simply put, the purpose of the Rapid Response Team is to bring critical care expertise to the patient bedside (or wherever it's needed)
A score of 80 % correct answers on a test is required to successfully complete any course and attain a certificate of completion.
Restraints are any actions or devices healthcare workers use to restrict a patient’s freedom (Scheepmans et al., 2017). The doctor, or RN using protocols, who follows up with the doctor, decides to use physical restraints. It is never OK for a CNA or HHA to start restraints without direction from a higher-level professional.
Certain conditions may make restraint use necessary when caring for patients for their safety:
Underlying conditions that may make restraint use necessary include:
Other methods of de-escalation should be tried when caring for agitated patients. De-escalation means taking action to try to keep the agitation from increasing. Restraints should be the last resort. Using restraints when caring for patients in healthcare can negatively affect patients and staff. Consequences can be physical, social and psychological.
Examples of physical consequences of restraint use include:
Social consequences include:
Psychological consequences include:
Restraint use can negatively affect family members by evoking feelings of anger, worry and guilt. Healthcare workers can also be negatively impacted by their feelings of guilt (Boyce et al., 2016).
The Joint Commission has stringent requirements for using restraints in the healthcare setting. State, hospital and facility policies usually define how often restrained patients are checked. They define how often the patient’s vital signs are taken. The policies also detail skin integrity, toileting, and range of motion rules. The restraints can and should be removed as soon as the patient is calm and quiet. However, staff should continue to monitor the patient carefully for both the patient’s safety and that of other patients and the staff (Boyce et al., 2016).
While restrained, patients must be watched closely. Some of the checkings may be delegated to the CNA or HHA.
Vital Signs: Heart rate, blood pressure, temperature, oxygen saturation and respiratory rate.
Patient comfort: skin chafing under and around the restraints, hydration, personal hygiene and toileting needs.
De-escalation techniques should be tried before restraints are used. There are 3 phases of escalating violence. They are:
These patterns of aggression are somewhat predictable. Developing violence can be identified before aggression takes place.
One technique is asking the patient, “how can we assist you?” This technique allows the healthcare worker to engage the patient while displaying compassion. Often this is sufficient to put an agitated patient at ease. Another technique is offering the patient food and drinks and helping with toileting if appropriate.
The goal is to treat the patient with dignity and empathy. If the patient continues to be agitated, untrained staff should immediately enlist the help of a trained staff member who can help defuse a potentially violent patient encounter. If the patient continues to be violent despite these efforts, facility security should be called to help keep the patient, staff and other patients safe. When security does arrive, they should gather at a safe distance but within the patient’s view. Sometimes a show of force is all that is required to calm the patient (Boyce et al., 2016).
Safety in caring for the elderly sometimes requires the use of restraints. Overall, using restraints and restricting mobility in elderly people will result in loss of function in the long run (Dahlke et al., 2019).
Several things cause problems in safety when caring for elderly patients. These include:
Leaders at the institutional level must address organizational factors that increase the use of restraint; these may be poor staffing.
Seclusion can be used in both inpatient units and specialized psychiatric units. It was used a lot in the 1980s, but its use has declined due to nursing staff shortages. In addition, most hospitals do not have space to provide seclusion to all patients who need it. Seclusion is a very effective technique for use in aggressive patients.
Note that seclusion can be combined with other forms of restraints, including physical or chemical restraints. Patients placed in seclusion must be reassessed as often as those placed in physical restraints (Kowalski, n.d.).
Physically restraining a patient’s limbs is the most common form of physical restraint. Limb restraints can be made from different materials, including leather and cotton. In general, restraints have to be comfortable, easy to apply, easy to remove and easy to clean. Of note, leather restraints are difficult to break or tear, but they are difficult to clean if they get soiled from bodily secretions. Sometimes hard leather restraints have a difficult application and removal processes relative to soft form restraints. Furthermore, that can be problematic when the patient is crashing in an acute setting. Leather limbs are usually reserved for combative and violent patients in whom the need for secure restraints is considered more important and worth the time it takes to apply or remove them (Kowalski, n.d.).
Soft limb restraints are made from cotton or foam material, a single-use device. They are less rigid than hard restraints and are easier to apply. Soft restraints are reserved for patients who are agitated but are less aggressive. Soft limb restraints are less secure than hard leather restraints(Kowalski, n.d.). (Kowalski, n.d.). Four-point restraints are restraints on both arms and legs.
Fifth-point restraints, or belts, are used as an adjunct to the four-point restraint. It functions by restricting the movement of the patient’s torso, pelvis or thighs. Fifth-point restraints are reserved for patients who continue to be dangerous to themselves or others while in a four-point restraint. It can also be used in patients whose behavior prohibits the medical staff from administering medically necessary care, including therapeutic interventions (Kowalski, n.d.).
Patients with a 5-point restraint are at increased risk of aspiration because they cannot turn to their sides if they start vomiting. Also, note that the 5-point restraint must be applied tight enough to prevent the risk of accidental suffocation in case the patient tries to slip under the restraint. These restraints usually require quick-release locks in an emergency (Kowalski, n.d.).
Jacket and vest restraints are reserved for inpatients or patients in longer-term facilities. There are reports of death with the use of jackets or vests related to choking and suffocation (Kowalski, n.d.). In general, jackets and vests are rarely used in emergencies (Kowalski, n.d.).
Leg restraints are used in the transportation of patients. Leg restraints are limited in the inpatient or emergency setting (Kowalski, n.d.).
Restraints prevent agitated or violent patients from harming themselves, other patients or staff members. Restraints should only be used as a last resort after de-escalation techniques have failed. Patients who are noted to be an immediate danger to themselves or others should be promptly restrained without delay.
Patients may need to be restrained to receive life-saving medical care. For example, patients who are intubated and or patients who are sedated and require life-saving treatment.
In addition, patients at risk for elopement (escaping) may also be restrained in very specific circumstances.
Restraints should not be used when de-escalation techniques are adequate. Restraints should not be used on broken limbs, open wounds or skin infections. Also, restraints should be used cautiously in patients with poor vascular circulation. Fifth-point restraints should be avoided in patients with ostomies, feeding tubes, pelvic fractures or multiple rib fractures. Finally, patients with severe pulmonary or cardiovascular disease may not tolerate the presence of a fifth-point restraint over their chest.
Restraints should be applied rapidly and safely by personnel who are trained in the application of restraints. The restraints must be tied to a non-moving part of the bed frame out of the patient’s reach. A slip knot must be used so that restraints can be untied quickly.
When applying restraints to an actively violent patient, a team of five members is recommended, one team leader and one individual for each limb. Occasionally the presence of multiple team members will be enough to subdue the patient with the need to apply restraints. The patient and family members must be educated about why the restraints are being applied. Also, they should always get clear instructions on the entire procedure.
Increased agitation can prevent good communication (Boyce et al., 2016).
Local skin breakdown: physically restricting the patient can prevent them from repositioning and moving. This restriction increases the risk of developing pressure ulcers.
Blood flow problems: If restraints are applied too tight, there is an increased risk of restricting blood flow to a limb.
Breathing problems: Patients with moderate to severe respiratory disease are at risk for breathing problems. For example, a patient with severe obstructive lung disease is at increased risk of respiratory failure if they are in a vest restrained or if they receive certain medication. Tied flat patients cannot easily move to throw up or spit.
That liquid might be sucked back into the lungs, causing pneumonia.
Heart problems: Patients with severe congestive heart failure may be unable to lay flat. If restrained and forced to lay flat, they may be at increased risk of heart and respiratory problems.
You are working with a patient in four-point restraints. You are required to toilet the patient every hour while awake. When you re-tie the restraints, you check the tightness to be sure the blood flow is not cut off. If you do not check, a restraint that is too tight can cut off blood flow to the hand or foot. This cutting off blood flow could cause the patient to lose the use of the hand or have to remove the hand.
Healthcare workers are responsible for caring for patients even when they cannot make appropriate decisions for themselves. At times, ensuring a patient’s safety and the safety of others will require the use of restraints. If necessary, workers must provide compassionate care that follows state, federal and institutional policy.