Bradley Buchanan presents to the neighborhood nurse-run clinic with shortness of breath, a persistent cough with blood-tinged sputum, recent weight loss, and night sweats. On initial assessment, the client has a fever of 101.4°F and pain in his chest. His other vital signs are as follows: pulse 98 beats per minute; respirations 26 per minute; blood pressure 110/76 mm Hg; height 68 inches; and weight 140 pounds. Mr. Buchanan is 45 years old. He is employed as a dishwasher at a local restaurant and lives at the local shelter with his wife, who is 8 months pregnant, and his 13-year-old son. Mr. Buchanan is concerned that if he cannot go to work, he will lose the family’s only income. At this point, although Mr. Buchanan’s signs and symptoms and his purified protein derivative test results seem to indicate that he may have tuberculosis, the nurse must pursue further confirmation of the diagnosis.
Questions for students:
- What would be the nurse’s next action?
- Should the nurse do any testing on the client or his family?
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