ND is a 82-year-old female who lives in a skilled nursing facility. She suffers from rheumatoid arthritis, coronary artery disease, chronic bronchitis, and hypertension. She is wheelchair bound and tends to spend most of her days in bed. She smoked for 52 years but quit 14 years ago. She has lost 10 pounds in the last month and has had a productive cough for about 2 weeks that has copious amounts of white to yellow mucous. Over the last 3 days, she has refused to get out of bed and has been refusing to eat or drink. This morning she is confused, has a fever, and is coughing continuously. Her sputum now is rust-colored. Her lungs sounds are coarse rhonchi throughout with crackles and diminished lung sounds in her right middle lobe area. Her vital signs are BP 86/54, HR 98, RR 28, and temperature 102.4. She is being admitted to the hospital.
Pneumonia can be classified many different ways. Which classification of pneumonia best fits ND’s situation? Explain. What is the most probable cause of ND’s pneumonia? Which diagnostic tests would you expect to be done to diagnose ND’s pneumonia?
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