An older adult patient with chronic obstructive pulmonary disease (COPD) develops bronchitis. The patient has a temperature of 39.5° C. The nurse will expect the provider to:
a. obtain a sputum culture and wait for the results before prescribing an antibiotic.
b. order empiric antibiotics while waiting for sputum culture results.
c. treat symptomatically, because antibiotics are usually ineffective against bronchitis.
d. treat the patient with more than one antibiotic without obtaining cultures.
ANS: B
Patients with severe infections should be treated while culture results are pending. If a patient has a severe infection or is at risk of serious sequelae if treatment is not begun immediately, it is not correct to wait for culture results before beginning treatment. Until a bacterial infection is ruled out, treating symptomatically is not indicated. Treating without obtaining cultures is not recommended.
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