The primary care NP sees a child in the clinic who has a 5-day history of cough, poor fluid intake, and fever of 103° F. A chest radiograph shows areas of consolidation in the child's lungs
The child's cough is nonproductive, and the NP is unable to get a sputum specimen. The NP should: a. prescribe a broad-spectrum antibiotic to cover any possible causative organism.
b. ask colleagues in the clinic about children they have treated and what they have prescribed.
c. give the child's parents a specimen cup and ask that they try to bring in a sputum specimen for culture.
d. refer the child to a pulmonologist or infectious disease specialist to help determine the proper treatment.
B
The child shows signs of a bacterial infection, but getting a sputum culture is not likely. The NP should ask colleagues about similar cases and treat according to those patterns. Broad-spectrum antibiotics increase the incidence of resistance. If this child's symptoms do not respond to empiric therapy, referral may be warranted.
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