ND is an 82-year-old woman who lives in a skilled nursingfacility. She has rheumatoid arthritis, coronary artery disease,chronic bronchitis, and hypertension. She uses a wheelchair andtends to spend most of her days in bed. She smoked for 52 years butquit 14 years ago. She has lost 10 lb in the past month and has hada productive cough for about 2 weeks that has copious amounts ofwhite to yellow mucous. Over the past 3 days, she has refused toget out of bed and has been refusing to eat or drink. This morningshe is confused, has a fever, and is coughing continuously. Hersputum now is rust colored. Her lungs sounds are coarse rhonchithroughout with crackles and diminished lung sounds in her rightmiddle lobe area. Her vital signs are blood pressure, 86/54 mm Hg;heart rate, 98 beats/min; respirations, 28 breaths/min; andtemperature, 102.4°F. She is being admitted to the hospital.
1.Pneumonia can be classified many different ways. Discuss thedifferent classifications and identify which classification ofpneumonia best fits ND’s situation.
2.What is the most probable cause of ND’s pneumonia?
3.What diagnostic tests would you expect to be done to diagnoseND’s pneumonia?
4.Describe what “CURB 65” is and whether ND meets thecriteria.
