A family brings their elderly father to emergency department. He has been exposed to pneumococcal pneumonia at his retirement home. Today, they noted a change in his mental status
They thought he might need some oxygen. Which of the other assessment findings would correlate with this diagnosis? Select all that apply.
A) Expiratory wheezes throughout all lung fields
B) Increase in chest pain with deep inspiration
C) Absent breathe sounds on the entire right side of the lung
D) Loss of appetite for past few days
E) Purulent sputum with bloody patches
Ans: B, D, E
Feedback:
During the initial stage, coughing brings up watery sputum and breath sounds are limited, with fine crackles. As the disease progresses, the character of the sputum changes; it may be blood tinged or rust colored to purulent. Pleuritic pain, a sharp pain that is more severe with respiratory movements, is common. Elderly persons are less likely to experience marked elevations in temperature; in these persons, the only sign of pneumonia may be a loss of appetite and deterioration in mental status. Expiratory wheezes are usually associated with asthma. Absent breath sounds on an entire lung field usually is associated with pneumothorax or respiratory failure.
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