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Question 5 / 6 Note: You will not have another attempt on this question if you navigate away. Please take your time answering this question before moving forward. Take Action Review the electronic health record and respond to the question that follows. History & Physical Progress Notes Laboratory Results Date/Time History & Physical 03/12/20XX 0534 ​Chief Complaint: fatigue, shortness of breath with productive cough​ History of Present Illness: Alfonso Smith (pronouns he/him/his), a 74-year-old male, presents with complaints of fatigue, dyspnea, and a cough with yellowish-red tinged sputum. He was diagnosed with a viral upper respiratory tract infection 2 days ago and states, “I am getting worse.” Up to date with influenza and COVID vaccinations. Negative influenza and COVID tests.​ Medications: Multivitamin, ferrous sulfate, calcium carbonate, metformin, Lipitor​ Past Medical History: type 2 diabetes mellitus, anemia, hypercholesteremia ​ Review of Systems:​ General: Clean, well-groomed appearance​ Neurological: Alert and oriented to person, place, time, and situation (A&O x 4)​ Cardiovascular: Tachycardic. S1 and S2 are present, and the capillary refill is less than 3 seconds Respiratory: Respirations shallow and rapid at rest; Inspiratory crackles​ Gastrointestinal: Reports regular, daily bowel movements. Denies abdominal pain​ Genitourinary: Denies any GI symptoms​ Musculoskeletal: Denies any pain. Ambulates unassisted Integumentary: Skin pink, warm, and dry Allergies: None reported​ Social History: Retired; lives with spouse​ Family History: No significant family history was reported​ Vital Signs: Temperature: 101.4 °F (38.6 °C); Heart rate: 102 bpm; Respiratory rate: 32 breaths per minute; Blood pressure: 136/76 mmHg; Pulse oximetry: 95% on room air The nurse practitioner (NP) must prescribe additional orders due to the client’s confirmed diagnosis of bacterial pneumonia. Which two (2) actions should the nurse prioritize? Select 2. Repeat arterial blood gas (ABG) – call results Albuterol 2.5 mg/kg per nebulizer every 1-4 hours, PRN Albuterol 2.5 mg/kg per nebulizer every 20 minutes for 3 doses Increase intravenous (IV) 0.9% normal saline (NS) infusion to 250 mL/hour Methylprednisolone sodium succinate 30 mg/kg intravenous (IV) every 6 hours Azithromycin 500 mg IV x 2 days, then 500 mg orally (to complete a 7- to 10-day course of therapy
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