A patient with right lower-lobe pneumonia has been treated with IV antibiotics for 3 days. Which assessment data obtained by the nurse indicates that the treatment is effective?
The patient's white blood cell (WBC) count is 6000/μL.
Bronchial breath sounds are heard at the right base.
Increased tactile fremitus is palpable over the right chest.
The patient coughs up small amounts of green mucus.
The Correct Answer is A
A. A decrease in the white blood cell count toward normal levels indicates that the infection is responding to antibiotic treatment. A WBC count of 6000/μL is within the normal range for adults (usually 4,000–11,000/μL), which suggests that the body is no longer fighting a significant infection.
B. Bronchial breath sounds heard at the right base indicate consolidation, a sign of ongoing pneumonia or unresolved infection. This would suggest that the infection is not yet controlled, rather than an improvement.
C. Increased tactile fremitus indicates consolidation, which is commonly seen in pneumonia. It suggests that the infection is still present and has not resolved with treatment.
D. Green mucus can indicate the presence of purulent sputum and ongoing infection. Although the color of the mucus may change during the course of pneumonia, the presence of green mucus does not confirm that the infection is resolving, especially after three days of antibiotics.
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Related Questions
Correct Answer is B
Explanation
A. While assessing sputum is important to determine its color, consistency, and amount, it is not the priority before performing percussion, vibration, and postural drainage. The nurse should first assess the patient's overall respiratory status.
B. Assessing pulse and respirations is the first step in ensuring the patient's baseline respiratory status is stable before performing respiratory therapies. This allows the nurse to detect any signs of distress or abnormal respiratory patterns, which could indicate the need for further intervention before the procedure.
C. Auscultating lung fields is important for evaluating the effectiveness of the percussion and drainage procedure, but the initial assessment should include vital signs, such as pulse and respirations, to ensure the patient is stable.
D. Instructing the patient to slowly exhale with pursed lips is a helpful technique for managing respiratory distress, but it is not the first priority before conducting percussion or postural drainage. The nurse should first assess vital signs.
Correct Answer is B
Explanation
A. Fecal output from a new colostomy typically begins within 2 to 4 days, not within 24 hours. This is due to the time needed for bowel function to resume after surgery.
B. A small amount of bleeding around the stoma can occur as part of normal healing, especially in the first few days after surgery. It should not be excessive or prolonged.
C. Raw vegetables and high-fiber foods should be avoided immediately after surgery as they can irritate the digestive tract and cause blockages in the stoma. A low-fiber diet is recommended initially.
D. The stoma should initially be red or pink in color, not purplish. A purplish color could indicate impaired circulation, which would require medical attention.
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