Question

PN 200 Fundamentals of Nursing II Concept Map - Pneumonia The sister of Calvin Kline called to report that her 71 year-old brother came down with a fever 2 days ago. Now he has shaking chills, productive cough, inability to lie down to sleep because “He cannot stop coughing" Mr. Kline is examined at the hospital's Primary Care Clinic, and is diagnosed with community acquired pneumonia (CAP) and now is admitted to your floor. The intern is busy and asks you to complete your routine admission assessment and call him with your findings. Your assessment findings are as follows: Mr. Kline's vital signs are B/P 154/82, P. 105, R. 32, and T. 103 F. on room air. 02 sats on room air are 84%. You auscultate decreased breath sounds in the LLL interiorly and posteriorly, course crackles LUL. His nail beds are dusky on fingers and toes. He has a cough productive of rust-colored sputum and complains of pain in his left chest when he coughs. Mr. Kline appears to be Well nourished and adequately wellhydrated. He is a lifetime non-smoker, non-drinker. Past medical history CAD/MI X 2/stent X 3. On metropolol, amiodipine, Lisinopril, furosemide, type 2 diabetes mellitus on metformin and roliglitazone. He reports that he has not been sexually active for 15 years but was always monogamous with his wife of 49 years. He has never gotten a flu or the Pneumovax vaccines. He does report getting hives when he took an antibiotic pill a few years ago but does not remember the name of the antibiotic 2. Which of these assessment findings concerns you? (State what each symptom represents) 3. What do the abbreviations CAD and MI mean? 4. Why would each of the medications listed would be prescribed for this patient (state the action of each medication listed)? Revised 9/12

Answer 1

1.blood pressure= 154/82mm Hg

He has high blood pressure which shows the strain he has with pneumonia.

Temperature = 103 degree farenheit

His has infection and body tries to manage it.

Oxygen saturation is 84%

Oxygen exchange in between the lung and blood is not enough.

Crackle sound in auscultation is due to fluid in tghe lungs which interfere oxygen exchange.

Absence of breath sounds indicates accumulated air or fluid in or surrounding the lung.

Dusky fingers and toes, due to inadequate gas exchange.

Rust coloured sputum, main indicator of pneumonia by streptococcus pneumoniae , sputum contains bacteria,blood, necrotic tissues.

2. MI - myocardial infarction ( decreased blood supply to myocardium)

CAD- coronary artery disease. ( Blockage of heart vessels due to thrombus ).

3. Metoprolol - it act against epinephrine to reduce heart rate, blood pressure, and strain on heart.

Amiodipine- dilates blood vessels to reduce blood pressure and helps heart to pump smoothly.(calcium channel blockers)

Lisinopril- (angiotensin converting enzyme) to dolate blood vessels and lower blood pressure to improve blood supply to heart.

Furosemide- ( loop diuretric) reduces blood pressure by promoting sodium excretion through urine.

Metformin - reduce the release of glucose by the liver and helps body to respond to insulin.

Roliglitazone- it improves insulin sensitivity and helps to control blood sugar level.