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A nurse is assisting with the care of a 15-year-old adolescent who has Streptococcus pneumonia.

Exhibits

The nurse is collecting data on the adolescent 24 hr later. How should the nurse interpret the findings?

For each finding, click to specify whether the finding is unrelated to the admitting diagnosis, an indication of potential improvement, or an indication of potential worsening condition.

A.

WBC count 17,000/mm3

B.

Steatorrhea

C.

Oxygen saturation 95% on 1 L oxygen via nasal cannula

D.

Barrel chest

E.

Hemoptysis 300 ML

F.

Respiratory rate 32/min

Answer and Explanation

The Correct Answer is {"A":{"answers":"B"},"B":{"answers":"A"},"C":{"answers":"B"},"D":{"answers":"A"},"E":{"answers":"C"},"F":{"answers":"B"}}

WBC count 17,000/mm3: Indication of Potential Improvement. The initial WBC count was 22,000/mm3, and 24 hours later, it has decreased to 17,000/mm3, indicating improvement.

Steatorrhea: Unrelated to Diagnosis. This symptom is typically associated with cystic fibrosis rather than pneumonia.

Oxygen saturation 95% on 1 L oxygen via nasal cannula: Indication of Potential Improvement. The decrease in oxygen requirement from 2 L to 1 L suggests the adolescent's respiratory status may be improving.

Barrel chest: Unrelated to Diagnosis. This physical finding is more indicative of chronic conditions such as cystic fibrosis rather than an acute pneumonia presentation.

Hemoptysis 300 mL: Indication of Potential Worsening Condition. The presence of significant hemoptysis indicates a worsening condition, possibly due to progression or complications of pneumonia.

Respiratory rate 32/min: Indication of Potential Improvement. The decrease in respiratory rate from 36/min to 32/min suggests a possible improvement in respiratory status.


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Related Questions

Correct Answer is C

Explanation

A. Meperidine is not recommended for pain management in sickle cell crisis due to the risk of seizures and neurotoxicity. Fever should be managed with antipyretics like acetaminophen.
B. Increasing, not decreasing, daily oral fluid intake is important to help reduce blood viscosity and prevent further sickling of red blood cells.
C. Maintaining bed rest helps to reduce oxygen demand and prevent hypoxemia, which can exacerbate the vaso-occlusive crisis.
D. Applying cold compresses is not recommended as it can cause vasoconstriction and worsen the pain. Warm compresses are more appropriate for managing pain in sickle cell crisis.

Correct Answer is {"A":{"answers":"A"},"B":{"answers":"A,B"},"C":{"answers":"A,B"},"D":{"answers":"A"}}

Explanation

Acute Laryngotracheobronchitis (Croup): This condition typically presents with a barking, seal-like cough and inspiratory stridor due to inflammation of the upper airway, often caused by a viral infection such as parainfluenza virus.

Pneumonia: While irritability and fever can be present in both conditions, the presence of stridor (especially inspiratory) is more characteristic of Acute Laryngotracheobronchitis. Pneumonia typically presents with a productive cough, fever, and signs of lower respiratory tract involvement such as crackles or decreased breath sounds on auscultation.

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