Case Study
ND is an 82-year-old female who lives in a skilled nursing facility. She suffers from rheumatoid arthritis, chronic bronchitis, and hypertension, and PVD. She is wheelchair-bound and tends to spend most of her days in bed. She smoked for 52 years but quit 14 years ago. She has lost 10 pounds in the last month and has had a productive cough for about 2 weeks that has copious amounts of white to yellow mucous. Over the last 3 days, she has refused to get out of bed and has been refusing to eat or drink. This morning she is confused, has a fever, and is coughing continuously. The skilled nursing facility transfers her to the ER.
In the ER her sputum is rust-colored. Her lung sounds are coarse rhonchi throughout with crackles in her right middle lobe area. Her vital signs are BP 86/54, HR 98, RR 28, and temperature 102.4. She is being admitted to the hospital to rule-in community-acquired PNA.