Question

An 88-year-old female was seen in the physician’s office complaining of SOB, dizziness, orthopnea, elevated temperature, and a productive cough. Lung auscultation revealed rales over the R bronchus. CXR revealed fluid in the RUL. The patient was sent to the hospital with an admitting diagnosis of pneumonia. Vital signs upon admission were: temperature 102°F, pulse 100 and rapid, respirations 24 and labored, blood pressure 180/110. She was treated with IV antibiotics and IPPB. She responded well to treatment and was released home to her family with oral antibiotics on the third day. 1. What is this patient’s admitting diagnosis? Look this condition up in a reference source and include a short description of it. 2. List and define each of the patient’s presenting symptoms in your own words. 3. Explain the change in her medication when she was discharged home.

Answer 1

1)The admitting diagnosis may be made as " Fever under evaluation" .This helps us to rule out the actual cause of fever.

2)Elevated temperature is because of infection n the lung because of the secretion

SOB is due to the congestion making breathing difficulty.

Narrowing of the respiratory tract makes breathing difficulty like orthopenia due to inflammation

A rise in pulse and respiration is due to the fluid collection in the lung

3) The antibiotic course depends on the severity of infection.Here after 3 days of IV antibiotic administration her symptoms have been eased and thereafter can be converted to oral antibiotic which can be even taken in home after discharge.The duration for treatment is 7 to 10 days upon the severity of infection.