A nurse in a provider’s office is assessing an older adult client whose son reports that the client has been sick with a respiratory illness for the past 6 days. Which of the following assessment findings is a manifestation of pneumonia in the older adult client?

Narrowed pulse pressure

Night sweats

Bradycardia

Confusion

Answer and Explanation

The Correct Answer is D

Choice A reason: Narrowed pulse pressure is not a specific manifestation of pneumonia in the older adult client. Pulse pressure is the difference between the systolic and diastolic blood pressure readings. A normal pulse pressure is about 40 mm Hg, and a narrowed pulse pressure is less than 25 mm Hg. A narrowed pulse pressure can indicate various conditions, such as heart failure, shock, or aortic stenosis, but it is not a sign of pneumonia.

Choice B reason: Night sweats are not a common manifestation of pneumonia in the older adult client. Night sweats are episodes of excessive sweating during sleep that can soak the bedding or clothing. Night sweats can have many causes, such as menopause, infections, medications, or cancer, but they are not typically associated with pneumonia.

Choice C reason: Bradycardia is not a usual manifestation of pneumonia in the older adult client. Bradycardia is a slow heart rate, defined as less than 60 beats per minute. Bradycardia can be normal in some people, such as athletes or those who are very fit, or it can be a sign of a problem with the heart's electrical system. Pneumonia does not cause bradycardia, but it can cause tachycardia, which is a fast heart rate, due to the increased oxygen demand and inflammation.

Choice D reason: Confusion is a frequent manifestation of pneumonia in the older adult client. Confusion is a state of impaired awareness, orientation, memory, or judgment. Confusion can occur in older adults with pneumonia due to several factors, such as hypoxia, dehydration, electrolyte imbalance, fever, or infection. Confusion can also increase the risk of complications, such as aspiration, falls, or delirium. Therefore, the nurse should monitor the mental status of the older adult client with pneumonia and report any changes to the provider..

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Correct Answer is B

Explanation

Choice A reason: Occasional bubbling in the water seal chamber. This finding does not indicate that the client is experiencing a complication, but rather that the chest tube is functioning properly. Occasional bubbling in the water seal chamber occurs when the client exhales, coughs, or sneezes, and it shows that air is being removed from the pleural space.

Choice B reason: Continuous bubbling in the water seal chamber. This finding indicates that the client is experiencing a complication because it suggests that there is an air leak in the chest tube system. An air leak can prevent the lung from expanding and cause respiratory distress.

Choice C reason: Fluctuations in the fluid level in the water seal chamber. This finding does not indicate that the client is experiencing a complication, but rather that the chest tube is functioning properly. Fluctuations in the fluid level in the water seal chamber occur when the client breathes, and they show that the pressure in the pleural space is changing.

Choice D reason: Constant bubbling in the suction control chamber. This finding does not indicate that the client is experiencing a complication, but rather that the chest tube is functioning properly. Constant bubbling in the suction control chamber occurs when the suction source is connected, and it shows that the suction is working.

A. Administer low flow oxygen continuously via nasal cannula. B. Encourage oral intake of at least 3,000 mL of fluids per day. C. Offer high protein and high carbohydrate foods frequently. D. Place in a prone position.

Correct Answer is D

Explanation

Choice A reason: Administer low flow oxygen continuously via nasal cannula. This intervention is not appropriate because it does not provide enough oxygen to meet the needs of a client with ARDS. A client with ARDS requires high flow oxygen delivered by a mechanical ventilator or a noninvasive positive pressure device.

Choice B reason: Encourage oral intake of at least 3,000 mL of fluids per day. This intervention is not appropriate because it can worsen the pulmonary edema and hypoxemia that occur in ARDS. A client with ARDS requires fluid restriction and diuretics to reduce the fluid accumulation in the lungs.

Choice C reason: Offer high protein and high carbohydrate foods frequently. This intervention is appropriate because it provides adequate nutrition and energy to support the client's metabolic needs and prevent muscle wasting. A client with ARDS has increased caloric and protein requirements due to the increased work of breathing and the inflammatory response.

Choice D reason: Place in a prone position. This intervention is effective because it improves oxygenation and ventilation by increasing lung volume and reducing the effects of gravity on the lungs.

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A nurse in a provider’s office is assessing an older adult client whose son reports that the client has been sick with a respiratory illness for the past 6 days. Which of the following assessment findings is a manifestation of pneumonia in the older adult client?

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A nurse in a provider’s office is assessing an older adult client whose son reports that the client has been sick with a respiratory illness for the past 6 days. Which of the following assessment findings is a manifestation of pneumonia in the older adult client?