A nurse is caring for a client who has tuberculosis. The client has a WBC count of 5,100/mm3 (5,000 to 10,000/mm3). Which of the following types of Isolation precautions should the nurse implement?

Nursing care for a client with Tuberculosis focuses on preventing transmission of airborne pathogens, especially in healthcare settings. Tuberculosis spreads through inhalation of droplet nuclei that remain suspended in the air for long periods. Isolation precautions are determined by the mode of transmission rather than the client’s white blood cell count. Therefore, strict airborne precautions are essential to protect both healthcare workers and other patients. Rationale: A. Contact precautions are used for infections spread by direct or indirect contact with contaminated surfaces or bodily fluids, such as MRSA or C. difficile. Tuberculosis is not transmitted through contact with surfaces or physical touch. Therefore, contact precautions alone are insufficient to prevent spread of the disease. B. Airborne precautions are required because tuberculosis is transmitted through small airborne droplet nuclei that can remain suspended and be inhaled by others. These precautions include the use of a negative pressure room and an N95 respirator for staff. This prevents airborne transmission and is the standard isolation method for active pulmonary TB. C. A protective environment is used to protect immunocompromised clients from environmental pathogens, such as those undergoing chemotherapy or bone marrow transplant. It involves positive pressure airflow and is the opposite of what is needed for infectious airborne diseases. Therefore, it is not appropriate for a client with tuberculosis. D. Droplet precautions are used for infections transmitted through large respiratory droplets, such as influenza or meningitis. These droplets typically travel short distances and do not remain suspended in the air. Tuberculosis requires airborne precautions because its infectious particles are much smaller and remain airborne longer than droplet-spread pathogens.