# Insider Info For Passing The TEAS

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Real-Deal information from TEAS testing insiders

You want to know the scoop on passing the TEAS, then let us tell you what some TEAS test insiders had to say.
Let’s just get the bad news out of the way, unfortunately there is a tremendous amount of preparation and study that will be needed, as it covers specific content areas. Now, I don’t know about you but when was the last time you took an academic based skills test? The thought of having to take a lengthy test on fundamentals might be overwhelming to some, but the good news is, we’re here to guide through the information that will be on the TEAS so you are not blindly walking into anything.

Like most academic testing the TEAS has four sections that you will be tested on, Reading, Math, Science and English all in varying amounts of time dedicated to each topic. Starting to sound like we’re in elementary school again? Let’s dive into each area a little more.

Math, you either love it or you hate it! The questions in this section will cover most everything from algebra to data and measurement. If you have been out of the math scene for a bit your skills might be a little rusty. Take the time to review the study guides and familiarize yourself with certain methods to solve different equations. Break out the old flash cards and give yourself a refresher course on fractions, converting percentages to decimals, and most basic math fundamentals (PEMDAS, anyone??). I know we have all grown accustomed to defaulting use of phones or computers for mathematical problems, but you will only be allowed use of a physical calculator for TEAS, so try to stick with that during your studies.

Next is science, for some people this may be the hardest section of the test. It will cover human anatomy, physical sciences and scientific reasoning. There is a significant amount of prior knowledge needed and you are encouraged to set aside extra time during your preparation to study the different processes. You will need to brush your basic knowledge of chemistry, physics and biology to name a few and maybe a sprinkle of population growth. Most questions will be directed around anatomy and body systems, I mean after all you are going to nursing school, but it won’t hurt to glance at the periodic table a couple times to file that in your mental notes. Good luck! I started having eye twitches already covering this information.

Whew! We made it through! I hope that was able to give you a little more insight on what to be expecting for TEAS and to plan accordingly. Preparation is you going to be your best friend during this time, utilize all practice material and get your timing down. Academic testing is no easy feat, but you have the tools necessary to ensure your success!

# 5 Tips For Managing Nursing School Stress

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Helpful techniques for surviving nursing school… from the experts that know.

It’s no surprise that nursing school is not only difficult to get into, but once you’re in, the real stress has only just begun. Surviving the entire nursing school process can often feel like a daunting and overwhelming feat. From classwork to clinicals, there’s an enormous amount of pressure that runs parallel with the pursuit of having a career in the nursing field.

Any tricks, hacks, techniques or “how-to’s” you can find, are definitely worth checking out. You never know what information might be sticky enough to become your new positive learning habits. 👍🏼

And these 5 simple tips from our friendly educational experts have been said to reduce nursing school jitters, increase confidence, and keep you in the game:

## No.1 – STUDY

Just like with one of the top fears/ phobias in the world (public speaking) the primary way to reduce such anxiety while increasing your confidence, is to be prepared. Whether a test, presentation, or simply being observed by an instructor/ doctor or authority in your field of study… being fully prepared will give your confidence the boost it needs by simply knowing you have retained the necessary information. This one crucial action alone will calm your nerves, and give you a real advantage among any procrastinating classmates choosing not to do the same.

## No.2 – TIME MANAGEMENT

When faced with multiple tests/ exams, deadlines, assignments, and a plethora of expectations from your instructors… it is vital that you take ownership of your time. While we all have different styles of time management and keeping ourselves in a system or routine, there’s really no “right” way to create a schedule. So the most effective way to establish a solid routine for yourself is by creating a customized system that works specifically for YOU. Simply setting the goal to always stay AHEAD of your educational demands will effectively reduce any unnecessary, and additional, stress

## No.3 – PASSION IS HUGE

There are so many different facets to explore within the nursing field, that by even minimizing your career objectives to “nursing” alone could possibly dismiss the key foundational aspects you might find to be your truest passion. From pediatrics to aesthetics, it’s truly necessary to lean into all nursing elements and options that bring you real excitement as you move through your classes and clinicals. These passionate understandings may evolve/ change as you learn and grow closer to your career goal in the medical field… and that’s totally okay. The real objective isn’t to pick your career in your first week of classes, but to stay engaged with the aspects that truly ignite your passion.

## No.4 – NETWORK LIKE CRAZY

In all reality, you could throw a rock and accidentally hit someone who’s been enrolled in a nursing program or is currently working in some facet of the field. Take advantage of these opportunities to meet them. Reach out, ask questions, utilize every moment allowed that they’re willing to share with you. The wisdom of another who’s been through the same process is truly priceless. (If anything, simply because they’re living proof that YOU can also make it through nursing school to find yourself in the career you’re working diligently toward.)

## NO.5 – PERSONAL TIME

You matter. Your mental and physical health are truly just as important as the grade you receive on your final exam. So, if you don’t already have a hobby you can use as an outlet – make it happen. Whether physical, creative, or not at all related to nursing… find one quickly. This could be yoga, rock climbing, painting, knitting, cooking, or even gaming… just as long as it allows you to do something that provides you with joy, happiness, and a sense of fulfillment, to allow for those necessary moments of separation from the looming pressures of nursing school.

Always remember that this path is YOURS to walk. Embrace the resources available to you for traveling this journey with less stress, more confidence, and real opportunity to truly find yourself in a fulfilling career you love, while serving and helping others. SimpleNursing will always have your back… so be sure to follow us, keep in touch, and let us know what you need to feel confident in this brave new venture.

(BECAUSE WE LIVE TO HELP NURSING STUDENTS BECOME ROCKSTAR NURSES!)

# TEAS Testing Success In 5 Easy Steps

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Test taking can often be a very stressful and overwhelming undertaking… especially when it’s concerning your future and career academic testing on steroids… a.k.a the TEAS. You can never be too prepared, and honestly the more prepared you are, the better the experience will be! When deciding to apply for nursing school, they (more than likely) advised you on all the fun requirements you have in store for your nursing school adventure. We know from personal experience just how daunting this entire process can seem… so we want you to know we’re here to support your entire journey, ALL the way through to graduation. (To kick it all off, here’s a quick “5-easy-steps” guide for a better TEAS testing experience.)

### No.1

##### Take the test PRIOR to applying for nursing school.

We know this might seem a little ahead of the game if you haven’t even applied yet, but… If you’re seriously wanting to get into nursing school, it’s definitely in your best interest to take a good run-through of the test so you know what to expect when the real deal comes along.

### No.2

##### Register in advance – don’t procrastinate.

Testing sites always encourage registration at least 2 weeks in advance to ensure there are no surprises when your test day arrives. Providing yourself with that extra time can help assist in staying calm, keeping your chill, and feeling more prepared by having a thorough opportunity to study your guides and testing materials. Going into “test day” stressed out will only lead to the dreaded brain fatigue that hinders your information recall and ability for thinking clearly with a calm, and collected mind. So be sure to give yourself the prep time you need and deserve!

### No.3

##### Utilize as many TEAS test prep resources you can find.

Regardless of your confidence level going into the exam, a broad range and use of testing resources are always recommended. Some of the more extensive resources might come with a small cost, but investing in the right one/ ones will only guarantee greater success on the official TEAS exam. You can reference the ATI website for different options available.. or this TEAS-Prep resource link will provide you with everything you need for studying and practicing until you feel ready for the real-deal.

### No.4

##### Review, review, review… and then maybe review.

With as much study time you’ll be putting in just to cover the amount of information included on the TEAS, it’s very possible for little bits of information getting lost or pushed aside, making the test day info-recall much harder to access. We highly recommend you take plenty of time to review all material in every topic before moving on to the next. A bulk of the questions found on each test will concern the basic fundamentals of math, writing, and reading we have had the wonderful pleasure of already learning. So dusting off any old school flashcards you might still have is another way to give yourself a little “refresher” on everything from decimals and fractions, to even the appropriate use of commas.

### No.5

##### Rest up… Get that sleep!

This small but powerful insider tip often gets looked over… but rest is very crucial to your test taking success, especially when it comes to such an important entry exam step toward your future. You’ll want to make sure you get a solid night of excellent sleep to help with alleviating unnecessary stress while allowing for a more clear mind that’s ready to work its way through the entire TEAS test, like a boss. A few other important rules to remember… make sure to eat a solid breakfast, definitely have a morning dance party to get your dopamine flowing (or anything that helps put you in a good mood) as being happy will always bring higher levels of confidence you’ll be very grateful to access during crucial moments of test-taking pressure.

Now that you have a few more insider tips to help lead you through this experience… we want you to know you are awesome and you’re gonna own the TEAS, pro-style! This all new chapter of your life is going to be an exciting and sometimes difficult one… but have no fear! Every single one of us at SimpleNursing are here to provide you with the support you’ll need as we cheer you all the way through this wonderful new adventure!

# How to Diagnose Acute Respiratory Distress Syndrome

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Before going into details on how to efficiently diagnose acute respiratory distress syndrome (ARDS), we’ll have a quick overview and some signs and symptoms.

## Overview

Acute respiratory distress syndrome (ARDS) develops due to the building up of fluids inside the alveoli or the microscopic, elastic sacs of air inside the lungs. This build-up of fluid will prevent or make it difficult for the lungs to be filled in with air, resulting in limited oxygen reaching the bloodstream. Decreased oxygen in the body compromises the entire system from working properly.

## Affectation

ARDS usually happens to people who are severely ill or those who have experienced critical injuries. As for those who already have ARDS, most of them do not survive, and the risk of mortality increases with the illness’ severity and age. As for those who do survive, they either have irreversible lung damage or will recover completely.

## Signs and Symptoms

The manifestations of ARDS change with intensity, and will significantly depend on the illness’ severity and cause; not to mention the presence of an underlying lung or heart disease. Some of the common signs and symptoms of ARDS are:

• Shortness of breath (SOB)
• Decreased blood pressure
• Extreme fatigue
• Confusion
• Rapid and labored breathing

## Diagnosis

How do we diagnose ARDS? How does one say that the client needs to be taken to the ICU as soon as possible? Here are the main criteria to accurately diagnose ARDS in a client:

1. ### Erroneous breathing

One of the main criteria for diagnosing ARDS is the inconsistency in breathing patterns since the lungs are primarily affected.

1. ### Oxygen saturation (SaO2)

If a post-operative client’s oxygen saturation has been steadily below 90% Sa02, it is one of the main indicators for ARDS.

1. ### Partial pressure of oxygen (PaO2)

The doctor will also order out an ABG test to see how much PaO2 or oxygen is going back to the pulmonary artery. If the result is anything less than 60%, that’s another criterion for ARDS.

1. ### Power of hydrogen (pH)

If the pH result is less than 7.30, this means that the blood’s acidity is high and will immediately affect the lungs.

To summarize, here are the things that healthcare practitioners should watch out for when trying to diagnose ARDS:

• SaO2 – less than 90%
• PaO2 – less than 60%
• pH – less than 7.3

#### Interpretation

Aside from distressed breathing, if the results show the indicators mentioned above, all it means is that the lungs are filling up with carbon di-acid or carbon dioxide, which makes it hard for the client to breathe.

While oxygen is not going inside the lungs and to the rest of the body, carbon dioxide is building up. Therefore, it is expected that carbon dioxide can go as high as 50mEq/L. This will cause the blood to become very acidic.

So, now that we are well aware of how acute respiratory distress syndrome is diagnosed, we will now proceed to the stages based on the severity of the illness; all this and more in our next article.

For more topics related to nursing, drop by Simple Nursing’s website and YouTube channel.

# Cellular Physiology: Sodium Potassium Pump

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For this sodium-potassium pump lesson, we’ll learn the essence and responsibility, and the overall mechanism of the enzyme.

The sodium-potassium pump can be quite a perplexing topic especially to nursing students due to its nature, function, and how the entire process contributes to healthier well-being.

## Sodium-Potassium Pump Explained

At this very moment, there is a diversified network of nerve impulses running throughout the human anatomy. However, none of these complex movements are possible without the help of the sodium-potassium pump because it is specifically designed to transport proteins that are found within the cell membranes. Cell membranes are semi-permeable external barriers of majority of cells inside the body.

### Function

The primary function of the sodium-potassium pump is to propel potassium ions inside the cell, and at the same time, extracting sodium ions from the cell. Due to this intricacy, the sodium-potassium pump is hailed as one of the most critical processes inside the body for without it, electrical signals will not be possible, and the cells will eventually deteriorate.

The sodium-potassium pump is notable in nerve cells, in the kidneys, and also plays an important role in heart contractions and blood pressure. One must thank the sodium-potassium pump for a steady heartbeat.

## The Cell Boat Story

So, how does the sodium-potassium pump operate? It’s quite simple. The sodium has to be taken from the cell, and potassium will take its place.

To facilitate effective recall of the sodium-potassium pump, we have created a short story about a sailboat, in this case, cell boat that wishes to catch fish and drain the boat of saltwater.

In the cell boat, the goal is to keep the saltwater, which is representative of sodium, from going inside the boat. If saltwater goes inside the cell boat, the natural thing to do is to get rid of that saltwater, pumping it out. We are avoiding abundance of sodium inside the cell.

On the other hand, if you’re going on a fishing trip, your primary goal is to catch as many fish as you can. The fish is representative of the potassium. Potassium being pulled in is essential for the cell boat because it is an electrolyte that is utilized for electric conduction and maintains fluid and electrolyte balance, above all things.

It’s that easy.

So, as a summary, the sailboat (cell boat) represents the cell, while the saltwater is the sodium and the fishes are potassium. You want seawater to be pumped out of the cell and potassium to be pulled into the cell to be used for contraction and conductivity.

### The Simple Nursing Way

Here at SimpleNursing.com, we create lectures and simplify topics to aid students to lessen stress while increasing success. For other lectures on fluids and electrolytes, hypotonic, isotonic, and hypertonic fluids, check out our website.

You can also drop by our YouTube channel for other fun and exciting videos that will definitely help you with your major nursing exams and the NCLEX®. Don’t miss this chance of cutting down your study time into half.

# OB Nursing Review: What is the Coombs Test for Rh Factor?

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For nursing students, the Coombs test for Rh factor in pregnant women can be quite confusing. To understand precisely what how the Coombs test works and what Rh factor is, we’ll be discussing that in this article.

## The Immune System

First, we have to know what happens inside the body to call for a Coombs test.

The immune system creates antibodies to shield the body from harmful elements like bacteria and viruses that could cause illnesses and diseases. Antibodies are designed to protect; however, on certain occasions, they are the ones causing the distress by mistakenly targeting the healthy cells inside the body.

Because not everyone’s blood cells are the same, especially red blood cells, the immune system is programmed to attack any signs of incompatibility occurring inside the body. This is where the Coombs test comes in. In specific cases, the Coombs test is done for Rh factor during pregnancy.

## The Coombs Test

The Coombs test simply meant to check the blood of the mother and fetus to determine what type of Rh factor they have, whether it’s a negative or a positive Rh factor. The Coombs test will also trace of antibodies attacking the red blood cells.

### Rh Factors Explained

Rh factors pertain to the type of blood the expectant mother and the fetus have. The mom can either have a negative or a positive Rh factor and whatever the Rh factor the mom has may or may not have a direct effect on the baby.

If the mother has a negative Rh factor and the baby has a positive Rh factor, the mother’s body will recognize that the baby’s blood is different from hers, thereby triggering the creation of antibodies against the baby’s positive antigen. The antibodies created will mix into the baby’s system and attack the red blood cells either before or after childbirth. This process is harmful, and at times, life-threatening for the baby.

## Mom Makeover

To turn things around, mothers who have Rh-negative blood will need a makeover through the administration of RhoGAM because we have to cease this unwanted attack by her antibodies to her Rh positive baby.

For the mom, RhoGAM acts as a shield against the Rh negative blood, which in turn, protects the baby.

### Tricky Exams

During major nursing exams and even the NCLEX®, this part of the test will be quite tricky because examiners love to test their students to determine if they really understand what the Coombs test is and how it is applied with the Rh factors of both mom and fetus.

Questions about the Coombs test and Rh factor will usually revolve around: What is the Coombs test for and is it meant to protect the mom or the baby?

The Coombs test just shows who between the mom and the child are Rh negative or Rh positive. If the mother is negative, that will be harmful to a positive Rh blood baby. The Coombs test is meant to protect the baby by shielding the mom of the antibodies that will affect the baby by giving the mom RhoGAM. Therefore, this entire process is meant to protect the fetus and not the mother.

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What is the difference between preload and afterload? This is one of most frequently asked questions and probably one of the most confusing topics that nursing students encounter during their lectures and clinical rotations.

To settle the confusion once and for all, we will provide you with the most uncomplicated answer.

## The Slingshot Analogy

The heart is an intricate organ that causes quite a bit of bewilderment, especially with nursing students. And one of the topics that bring about such confusion is concerned with preload and afterload.

Consider this analogy – the heart is like a slingshot; a slingshot that requires pressure when pulling and energy upon release.

### Preload: The Pulling Effect

The pulling action of the slingshot is called preload. Preload occurs so that there will be the pooling of blood that will either be pushed into the lungs or to the rest of the body. Preload is also referred to as the diastolic pressure inside the blood vessels.

### Afterload: The Release

Afterload, on the other hand, is the action when the slingshot is released. Basically, afterload is the amount of pressure that the heart has to overcome to enter the next phase, whether the blood will go inside the lungs or the peripherals. Afterload is also known as the systolic pressure inside the blood vessels.

## Quick Anatomy and Physiology

The heart has four chambers – right and left atria, and right and left ventricles. These chambers are also considered as rooms that have vital roles in the distribution and oxygenation of blood to various parts of the body.

Deoxygenated blood is received by the right atrium from the body and is pushed to the lungs by the right ventricle to be filled with oxygen. The left atrium will receive the oxygenated blood and will send it to the left ventricle. The left ventricle will distribute the oxygen-rich blood to the rest of the body.

Between the atria and the ventricles, the ventricles are considered as the essential rooms inside the heart because they’re responsible for the pulling and pushing of blood to the body.

## Summary

So just remember this:

• Preload – the stretching or pulling to fill the heart with blood
• Afterload – the release or push of oxygenated blood by the left ventricle to the lungs and the rest of the body

That’s it for our simplified preload and afterload explanation that was brought to you by SimpleNursing.com, the best student nurse website that has helped more 40,000 students all over the world.

### The Simple Nursing Method

Here at SimpleNUrsing.com, we create lectures and simplify topics to aid students to lessen stress while increasing success.

For an entire lecture series or to get your free trial to SimpleNursing.com, check out our website. You can also submit your question no matter how random whacky, or crazy it is; we have a link for that on our site. Each month, we randomly choose submissions, and maybe, just maybe, we’ll choose your question next.

You can also check out our YouTube channel for other fun and exciting videos that will definitely help you with your major nursing exams and the NCLEX®.

# 3 Easy Ways to Drastically Improve Your Exam Scores

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Hey, guys.

Let us a quick break from our usual discussions about nursing topics and deviate to three simple techniques that will immensely enhance your study habits, thereby boosting your exam scores big time. Once you get to know these methods, learning and remembering every subject will become far less complicated and more enjoyable.

Without further ado, here are Simple Nursing’s three ways to upgrade the way prepare, review, and retain all the vital nursing topics that are crucial in acing your major exams.

1. ## Collate and Highlight

This first technique is something that every student is familiar with – collating the notes and handouts and highlighting all major details that were repeatedly emphasized during class lectures or clinical exposures. Gather every single resource material that you have, pile them all up, and go through the necessary details, namely:

• Laboratory values
• Pathophysiology
• Nursing process
• Keywords
• Pharmacology
• Signs and symptoms
1. ## Pinpoint then Transfer

Here, notecards are of the essence. After highlighting every single word, line, or phrase, the next step is to go through all these highlighted portions, take them out, and write them on the note cards. These are not just ordinary notecards wherein you indicate summarized versions of the various topics. Here, you can do the following:

• Contrast and comparison between two diseases (e., acute renal failure versus chronic renal failure) – place only keywords that will help you remember every disease
• Phases and values using tables

By the end of this notecard series, you can expect to have quite a thick stack of notecards, around 50 pieces. Make sure that these notecards are ready at least three days before your major test because these are the only things that you will use to review and recall all the nursing subjects without having to go through all the overwhelming reference materials.

And the best thing about these notecards is that you can take them anywhere you go, whether it’s the beach or when you’re dining out. They are useful and convenient to use.

1. ## Answer 100 NCLEX® questions

Purchase an NCLEX® book of any kind, be it Saunders or Mosby, it doesn’t matter for as long as you have an NCLEX® book that you can answer.  With your notecard, you will apply what you know by recalling all the keywords and applying what you know by answering all the items in the book that you decided to purchase.

So, the trick here is to answer at least 100 NCLEX® questions in a day. This technique will significantly boost your test-taking strategy and give you a better idea as to how much you know regarding a specific subject or topic.

### Parting Words

By following this three-step tip, you will become more prepared in consolidating your study time, hopefully, scoring higher on your next major exam without wracking your brain through exhausting hours of reading and finding yourself more confused than ever.

Finally, breathe. If you have the right tools to help you achieve your goals, you will surely pass with flying colors. In Simple Nursing, we’ve managed to do the other duties for you like picking out the essential keywords and creating a more efficient way to remember all difficult and confusing topics. Just go through our blogs in our Simple Nursing website and check out our videos on our YouTube channel as well.

Good luck with your exams!

# Dosage Calculations: IV Drip Factor

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Assuring that every client is provided with the appropriate medication and dose is fundamental in safeguarding their welfare; this is one of the primary responsibilities of the healthcare team, especially the nurses.

In this lesson, we’ll be discussing the essential relevance of accurate dosage calculation, mostly focusing on intravenous drip factor or the drip rates. Remember, that when it comes to nursing care, it is vital for nurses to understand that the dose introduced to their clients may precipitate unwanted errors that may lead to severe complications.

## Drip Rates

The thing with drip rates is that there has always been an ongoing confusion amongst healthcare providers, but it’s quite simple if properly explained.

Calculating intravenous drip rates (gtt/min) would involve these three main elements:

• Total volume
• Drip factor
• Time

So, the formula usually goes as:

Total volume x drip factor ÷ time = flow rate (gtt/min)

## Smart Recall

We’ve established an easy way for you to recall the formula listed above. Just remember, “TV will make you deaf over time,” which, if interpreted is:

• TV = total volume
• Deaf = DF or dip factor
• Over = divided by
• Time = time prescribed by the physician

Before calculating any type of IV administration, don’t forget to write down the statement, “TV will make you deaf over time,” or repeatedly say it inside your head so that you are equipped with the correct formula.

### Formula application

A usual scenario inside a healthcare institution will be a physician ordering normal saline to be infused for a specified period. So, you have to determine how many drops (gtt) of normal saline should be given to the client in a minute.

An example would be:

Calculate the intravenous flow rate for 1 liter of normal saline in 8 hours. The drop factor is commonly around 15 gtt/mL. Take note that 1 liter of normal saline is equivalent to 1,000 mL, and time should always be 60 minutes. Depending on what the physician has ordered, time should be multiplied by 60 minutes. In this case, 60 minutes will be multiplied by 8.

So, going back to the problem, applying the formula would exhibit:

1,000 mL x 15 gtts/mL ÷ 480 min = 31.25 or 31 gtts/min

That’s it for our drip factors simplified.

#### Care Plan Bible and Drug Card

For more information on other calculations, please go to SimpleNursing.com where you can get our care plan bible. This bible includes over 70 top diagnoses concerning reasons why people are admitted to the hospital, and we have created an efficient and efficient care plan or a concept map for each one of them.

Aside from that, you can also get the 40 drug card which is essentially a drug card manuscript that lists the top 40 drugs with areas of nursing interventions, mechanism of action, contraindications, and drug interactions which is completely helpful for those of you who are planning on taking the NCLEX® or is facing with difficulties when it comes to nursing pharmacology.

You can also check out our Simple Nursing YouTube channel for other informative nursing videos or drop by our website to browse through various topics that are usually major exam favorites.

See you there!

# Tuberculosis Pathology and Assessment

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Tuberculosis (TB) is a bacterial infection that resides inside the lungs caused by Mycobacterium tuberculosis. While books and nursing lectures would insist that tuberculosis is a droplet precaution, the Centers for Disease Control (CDC) and Prevention would say otherwise.

According to the CDC, tuberculosis is an airborne precaution that can spread by breathing in the same air that an infected person breathes in, especially when the person coughs, sneezes, laughs, sings, and even speaks.

## Airborne Diseases

Airborne diseases can be categorized with MTV, which can be translated as:

• MMR (measles, mumps, and rubella)
• Tuberculosis
• Varicella (chicken pox)

Varicella and mumps are also under the category of contact precautions. Take note that MTV diseases are required to be placed inside a negative pressure room so that air is taken out, minimizing the risk of spreading the diseases.

### Breathing In the Same Air

Regarding pathology, what happens when you breathe in the same air as someone who has tuberculosis? This scary occurrence can happen especially when you’re in a crowded place or a small space. Breathing in the same air as with someone who has tuberculosis can put you at risk of having the disease.

Airborne precautions are mandatory for nurses who are caring for tuberculosis clients. Instead of the usual surgical mask, healthcare providers in charge of clients with tuberculosis wear N95 masks. N95 masks help in preventing inhalation of outside air.

## Pathology

As the bacteria goes inside the lungs, it spreads through the lymphatic system and into the bloodstream. Once the body’s immune system is alerted, the B cells will create antibodies against the infection and the T cells, which are the natural born killers, will attack the tuberculosis bacteria. The macrophages will then make a perimeter to quarantine the bacteria and cease reproduction and growth inside the lungs.

Unfortunately, the T cells cannot kill the bacteria; the best thing that they can do is to isolate the bacteria so it cannot spread out. It’s like putting the bacteria inside the prison. Captive bacteria are now called granulomas.

## Assessing Tuberculosis

When a client comes into the ER, they usually are not aware that they have TB. Therefore, there are a couple of ways to assess if this client has tuberculosis.

1. ### A blood-tinged cough

A blood-tinged cough related to tuberculosis usually comes out in NCLEX® . Hemoptysis is the medical term given to coughing up of blood.

1. ### Difficulty of breathing

Along with bloody sputum, there would also be the difficulty of breathing or dyspnea and pallor due to the infection and lack of oxygen exchange inside the lungs.

1. ### Crackles (rales)

Crackles are sounds that are distinguishingly heard clients are auscultated that are mainly caused by fluid accumulation inside the small airways of the lungs or the alveoli. Crackles can either be coarse or fine. Aside from tuberculosis, crackles can also be heard from clients with CHF, bronchitis, and pneumonia.

#### Other Lung Sounds

• Ronchi is snore-like sounds caused by airway secretions and are usually cleared by coughing.
• Wheezing is like a whistle, mostly manifested by clients with bronchitis, emphysema, and asthma.

These lung issues are usually resolved by bronchodilators and anti-inflammatories.

1. ### Anorexia

Loss of appetite can lead to anorexia or weight loss. When a person is sick and is experiencing lack of oxygen, the craving to eat becomes absent. Furthermore, the client gets easily tired or fatigued.

1. ### Night Sweats

Night sweats get worse in time, and it’s because of the infection brewing inside the body.

## Laboratory Tests

There are a couple of ways to confirm a diagnosis of tuberculosis.

1. ### X-ray

Granulomas that show on the x-ray result as small ducts or bumps indicate positive tuberculosis reading from radiology.

1. ### Sputum

The sputum test is done first thing in the morning so that the bacteria can brew overnight. This is done for three consecutive days, always upon waking up in the morning.

1. ### Skin test

A skin test, also known as a positive protein derivative (PPD) test that shows a raised lump within 48 hours indicates that there is a positive reaction. This means that the T cells and macrophages have effectively surrounded and caused inflammation to the protein injected in the arm.

1. ### Increased WBCs

If the tuberculosis infection has spread to other parts of the body, white blood cells will increase more than 10,000.

1. ### ESR

Erythrocyte segment rate (ESR), on the other hand, is more specific because this indicates the presence of inflammation, assisting with the diagnosis of tuberculosis.

A negative tuberculosis screening, also known as latent phase, does not necessarily mean that there is absolutely no sign of the bacteria inside the body. To achieve a negative result in a latent stage, the client should have the following outcomes:

• A negative chest x-ray
• Negative sputum cultures (done three times)
• Positive PPD test

A positive, active result will yield the following:

• Positive chest x-ray
• Positive sputum test

For our next video, we’ll be discussing the nursing intervention of tuberculosis clients. For other respiratory lectures and nursing-related topics, you can visit our SimpleNursing website and YouTube channel.