Reference no: EM133272424

Assignment:

A 50-year-old male presents to the Clinic with a cough and sputum production for the last four days. The sputum is described as thick and yellow. He also developed a headache, chills, and fatigue along with the cough. The patient is complaining of chest pain, explaining it as a " sharp " non-radiating pain on the right side of his chest when taking deep breaths and coughing. The patient reports he has not been eating " well " since getting sick but has taken Tylenol and lots of fluids.

Past medical history: The patient currently smokes cigarettes. He smokes 1 pack daily and has been a smoker for over 20 years. He is noted to have a "smoker cough " described as dry, non-productive, and occurring in the early mornings. He denies any alcohol or illicit drug use. He currently suffers from chronic hypertension and usual bouts of chronic bronchitis. He has not been diagnosed with bronchitis in the last 6 months-no other pertinent past medical history.

Physical examination: Vital signs: BP 153/75, Pulse 105 BPM, Temperature 100.3 F. His oxygen saturation is 93% on room air. Respiratory rate 20 breaths/ minute. The patient presents as a noticeably tired-looking individual. During coughing, the fit patient was noted to hold on to his right side and was able to bring up yellow sputum mixed with a streak of red blood. Percussion of bilateral lung fields yielded resonance, with the exception of the right lower lobe noted to be dull. Auscultation was noted with diminished breath sounds. Crackles were heard on the inspiration of the right lower lung. The rest of the physical examination yielded no abnormalities.

Diagnostic X-ray showed opaque patchy infiltrates in the right lower lobe of the lung. WBC was noted to be 17,000. Sputum culture results are pending.

1. Identify and explain the significance of the physical findings.

2. What host factors may have predisposed the patient to pneumonia?

3. What other diagnostic tests should be performed?

4. What will clean consolidated exudate from the patient's alveoli as he recovers?

5. What treatment plan would you devise for this patient?

6. How would you educate the patient to prevent pneumonia further?

Please provide references from reliable sources.