Interpret the ABG results: pH: 7.48, PaCO2: 28 mmHg, PaO2: 55 mmHg, HCO3-: 24 mEq/L, SaO2: 87%

Choice A reason: Ceftriaxone treats infection, but giving it before cultures risks sterilizing samples, skewing results. It’s critical therapy, yet obtaining accurate diagnostics first ensures targeted treatment, delaying antibiotics briefly.

Choice B reason: Antipyretics reduce fever, a symptom, not the cause. Cultures take priority to identify pathogens before comfort measures, as fever management doesn’t alter diagnostic or treatment urgency in this case.

Choice C reason: Blood and sputum cultures identify the causative organism in suspected infection (e.g., pneumonia). They must be obtained first, before antibiotics, to ensure accuracy, guiding effective therapy and avoiding false negatives.

Choice D reason: Monitoring glucose is routine, not urgent in acute infection unless diabetic crisis is suspected. Cultures precede this, as identifying the pathogen drives treatment, while glucose can wait without immediate risk.

Choice E reason: Monitoring intake and output tracks fluid status, useful but secondary in acute infection. Cultures are the priority to diagnose and treat effectively, as I&O doesn’t alter initial management decisions.

Choice A reason: Aspirin prevents thrombosis in coronary disease, not a primary heart failure treatment. It reduces ischemic risk but doesn’t address fluid overload or cardiac workload, lacking direct symptom relief in heart failure management.

Choice B reason: Lisinopril, an ACE inhibitor, reduces afterload and preload by vasodilation, easing heart strain. It manages heart failure symptoms like dyspnea by improving cardiac output, a cornerstone therapy for pump dysfunction.

Choice C reason: Insulin Glargine controls diabetes, not heart failure symptoms. It manages glucose, indirectly benefiting cardiovascular health, but doesn’t relieve congestion or improve hemodynamics, making it irrelevant to direct symptom management.

Choice D reason: Furosemide, a diuretic, reduces fluid overload in heart failure, alleviating dyspnea and edema. It lowers preload by increasing urine output, directly targeting congestion, a key symptom, in evidence-based practice.

Choice E reason: Metoprolol, a beta-blocker, slows heart rate, reducing myocardial demand in heart failure. It improves ejection fraction and symptoms like fatigue, a standard therapy for stabilizing cardiac function long-term.