A patient comes into a clinic complaining of cough, fever, and shortness of breath. The patient informs the health care provider that he is HIV positive
Upon physical exam, the family nurse practitioner (FNP) may note which of the following clinical manifestations of suspected Pneumocystis jiroveci pneumonia (PCP)? Select all that apply.
A)
Interstitial infiltrates on chest x-ray
B)
Respiratory rate of 32 with normal breath sounds
C)
Stridor when taking a deep breath
D)
Use of abdominal muscles to breathe while sitting on the exam table
E)
Night sweats that require clothing changes frequently throughout the night
Ans:
A, B
Feedback:
PCP is a common presenting manifestation of AIDS or people with compromised immune systems. The symptoms include cough, fever, shortness of breath, and weight loss. Physical exam demonstrates only fever and tachypnea (elevated respiratory rate) and normal breath sounds. Chest x-ray shows interstitial infiltrates. Night sweats are usually associated with tuberculosis infection.
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