Physiological Integrity Q 14

---

A client with bacterial pneumonia is admitted to the pediatric unit. What would the nurse expect the admitting assessment to reveal?

  

     A. High fever

     B. Nonproductive cough

     C. Rhinitis

     D. Vomiting and diarrhea

    

    

Correct Answer: A. High fever

---

If the child has bacterial pneumonia, a high fever is usually present. Increased temperature (usually more than 38 C or 100.4 F) or fever with tachycardia and/or chills and sweats is a major clinical finding. Physical findings also vary from patient to patient and mainly depend on the severity of lung consolidation, the type of organism, the extent of the infection, host factors, and existence or nonexistence of pleural effusion.

---

Option B: Bacterial pneumonia usually presents with a productive cough, not a nonproductive cough. The presence of a productive cough is the most common and significant presenting symptom. The lower respiratory tract is not sterile, and it always is exposed to environmental pathogens. Invasion and propagation of the above-mentioned bacteria into lung parenchyma at alveolar level causes bacterial pneumonia, and the body’s inflammatory response against it causes the clinical syndrome of pneumonia.

Option C: Rhinitis is often seen with viral pneumonia. Features in the history of bacterial pneumonia may vary from indolent to fulminant. Clinical manifestation includes both constitutional findings and findings due to damage to the lung and related tissue.

Option D: Vomiting and diarrhea are usually not seen with pneumonia. Atypical pneumonia presents with pulmonary and extrapulmonary manifestations, such as Legionella pneumonia, often presents with altered mentation and gastrointestinal symptoms.

---