TUBERCULOSIS - A COMPREHENSIVE REVIEW FOR THE CERTIFIED NURSE-MIDWIFE

Tuberculosis (TB) has reemerged as a major public health concern in th e United States, with increasing impact upon women of childbearing and childrearing age. As a primary health care provider, the certified nu rse-midwife (CNM) must be able to respond to a variety of client conce rns and questions. This article reviews the natural history and changi ng epidemiology of TB. An in-depth focus on skin testing describes com mon errors in administration and interpretation, and how to clearly ex plain the meaning of a positive PPD result. Clinical presentations of active TB are summarized, with their implications for pregnancy and fe rtility. The final sections discuss the workup of latent TB to rule ou t active disease and outline standards for management and therapy. Com bining a sound knowledge base with expertise in client education and c ounseling enables CNMs to make unique contributions to the broad effor t to contain the new TB epidemic.