J.R. is admitted to the hospital for a suspected respiratory infection and CF exacerbation. His mother helps
get him settled into the room.
Your assessment includes the following: vital signs: 115/76, 85, 28, 101.8 °
F (38.8 ° C) (oral) and spo2: 88% on room air. J.R. weighs 30 kg. Color: pale and dry with bluish-tinged nail
beds and clubbing; capillary refill 3 seconds. Respiratory effort labored; coarse productive cough; rhonchi
noted throughout; states he has pain of 3 to 4 of 10 with coughing. Thorax has a barrel-chest appearance;
patient appears thin with decreased muscle mass. Last void and bowel movement this morning, no prob-
lems. Patient anxious and answers questions in short phrases.
What are the common microorganisms that cause respiratory infections in children with CF?
Most children with CF colonize multiple organisms. These include Haemophilus influenzae,
Staphylococcus aureus, Pseudomonas aeruginosa, Pseudomonas cepacia (also known as Burkholderia
cepacia), Escherichia coli, and Serratia and Klebsiella organisms. Many CF patients become chronically
colonized. Methicillin-resistant S. aureus has emerged recently in CF patients. Patients might also
colonize with Candida or Aspergillus organisms.
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