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. O2 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 well hydrated. 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)?

Answer 1

1. O2 saturation is 84% that indicated saturation fall and decreased breath sounds indicates reduced air entry

a, on auscultation decreased breath sound and crackles : indicated inadequate air entry and excessive sputum in the air way

b, nail bed dusky : decreased capillary refill --- compromised peripheral circulation

c, rusty sputum is seen in pneumococcal pneumonia, differential diagnosis --- pulmonary embolism, lung cancer or pulmonary TB

d, chest pain due to congession

3. CAD coronary artery disease, MI myocardial infarction

4. metropolol : beta adrenergic blocker , an anti hypertensive

amiodipine : angioselective calcium channel blocker, an anti hypertensive

lisinopril: angiotensin converting enzyme inhibitor, an anti hypertensive

furosemide : loop diuretic, an anti hypertensive

metformine: oral anti hyper glycemic agent

rosiglitazone: they are sulfonyl ureas that increases insulin release by pancreas