The nurse is reviewing the results of a patient's diagnostic tests. Based on the chart, which physician order would the nurse question based on the patient's most likely diagnosis?
1. Fluid restriction of 1,500 mL per 24 hours
2. Up in chair as tolerated
3. Perform endotracheal suctioning as needed.
4. Administer azithromycin.
1
Rationale 1: After reviewing the patient's laboratory test results, the nurse would accurately determine that the patient has developed pneumonia. The nurse would encourage the patient to increase fluid intake to 2,500–3,000 mL per day to help liquefy the secretions in the lungs and make it easier to cough up and expectorate the secretions. The nurse would not expect the physician to write an order for fluid restriction.
Rationale 2: The patient should be encouraged to continue as much activity as tolerated.
Rationale 3: Endotracheal suctioning may be required if the patient's cough is ineffective.
Rationale 4: Azithromycin is a macrolide, a broad-spectrum antibiotic that is often effective against pneumonia.
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