Coughing Kip — Tuberculosis
Night sweats, weight loss, airborne isolation, RIPE
Kip's cough outlasts three roommates and two seasons. He wakes soaked every night, his belt keeps getting tighter, and one morning there is blood in the tissue.
Kip has a cough that has lasted three weeks, drenching night sweats and unexplained weight loss. Airborne precautions with a negative-pressure room and N95 respirators. Treatment is months of RIPE therapy — adherence is the whole game.
Read Coughing Kip's full story →The story arc
The setup
Kip lives in a crowded shelter and has HIV that he has not been treating.
The turn
A cough that will not quit for three weeks, night sweats, low-grade fever, and 15 pounds lost.
The crisis
He coughs up blood in the waiting room, sitting among a dozen people with no mask on.
The save
Negative-pressure room, staff in fitted N95s, three sputum specimens for AFB, then RIPE therapy with directly observed dosing.
NCLEX study section — Tuberculosis
What this chapter is testing: the recognition cues, the numbers and the priority action.
Study section: Respiratory
Take this chapter into practice questions on the same topic.