Before discontinuing airborne precautions for a client with tuberculosis, what must the nurse determine?

Determining that the sputum is free of acid-fast bacteria is essential before discontinuing airborne precautions for a client with tuberculosis. This is because the presence of acid-fast bacteria in the sputum indicates that the individual is still contagious and can spread the infection to others.

In clinical practice, it is vital to ensure that the patient has undergone appropriate treatment and has demonstrated a significant clinical response, which is typically evaluated through sputum testing. A negative sputum result indicates that the risk of transmission has significantly decreased, allowing for safe discontinuation of airborne precautions.

The other options, although relevant to the overall management of tuberculosis, do not directly address the ability to determine whether the client is no longer infectious. For instance, a negative tuberculin skin test might suggest that the client is no longer infected but does not alone confirm non-contagiousness. Similarly, normalization of temperature or the client being free from infection doesn't provide concrete evidence of reduced risk of transmission, as these symptoms can fluctuate independently of the presence of the bacteria in the sputum. Thus, confirming that sputum is free of acid-fast bacteria is the most reliable indicator for safely stopping airborne precautions.