What should a nurse do for a client who has an induration after receiving a Mantoux test?

When a client shows induration after receiving a Mantoux test, it indicates a reaction that needs to be assessed further. The Mantoux test is used to determine if a person has been exposed to tuberculosis bacteria. The presence of induration suggests a possible positive reaction, which requires careful documentation and follow-up to determine its significance for the client’s health.

Following up for further evaluation is essential because the size and characteristics of the induration can help categorize the reaction and guide subsequent medical decisions. A healthcare provider may need to consider the client’s history, risk factors for tuberculosis, and overall clinical picture to confirm or rule out an active infection or latent tuberculosis.

Ignoring the induration could potentially lead to a missed diagnosis and delay appropriate treatment, while administering steroids is not a standard response because it could suppress the immune response and complicate the interpretation of the test. Likewise, notifying emergency services would not be appropriate unless there are acute life-threatening symptoms, which are not typically associated with a simple test result like the Mantoux. Therefore, documenting and ensuring proper follow-up for evaluation is the most appropriate and professional response.