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(Solved): Harry Smith, 70 years of age, is a male patient admitted to the medical-surgical unit with acute com ...



Harry Smith, 70 years of age, is a male patient admitted to the medical-surgical unit with acute
community-acquired pneumonia. He was diagnosed with paraseptal emphysema 3 years ago.
The patient smoked one pack of cigarettes per day for 55 years; he quit 3 years ago. The
patient has a history of hypertension and diabetes controlled with oral diabetic agents.
The patient presents with confusion as to time and place. The family stated that this is a new
change for the patient.
The admission vital signs are blood pressure, 90/50 mm Hg; heart rate, 101 bpm; respiratory
rate, 28 breaths/min; and temperature, 101.5°F. The pulse oximeter on room air is 85%. The
CBC is as follows: WBC, 12,500; platelets, 350,000; HCT, 30%; and Hgb, 10 g/dL.
ABGs on room air are pH, 7.30; PaO2, 55; PaCO2, 50; and HCO3, 25.
Chest x-ray results reveal right lower lobe consolidation, presence of apical bullae, a flattened
diaphragm, and a small pleural effusion in the right lower lobe.
Lung auscultation reveals severely diminished breath sounds in the right lower lobe and
absence of breath sounds at the base. The breath sounds in the rest of the lungs are slightly
decreased.
The patient complains of fatigue and shortness of breath and cannot finish a short sentence
before the respiratory rate increases above the baseline. His nail beds and lips turn a bluish
tinge, and the pulse oximetry decreases to 82%. The patient is diaphoretic and is using
accessory muscles. The patient coughs weakly, but he does not raise any sputum.
a. What nursing assessment findings support the diagnosis of pneumonia?
b. What diagnostic findings support the diagnosis of pneumonia?
c. What goals should the nurse develop for the patient?
d. What interventions should the nurse provide first?
E. What additional recommendations would the nurse provide to the HCP?



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a. Nursing assessment findings supporting the diagnosis of pneumonia: ->Presence of fever (temperat...
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