[Expert Solution]: Mr

Mr. K, a 76-year-old male, is admitted to the hospital’s emergency department. He lives independently at home, and reports that during the past two weeks, he has been experiencing a “stuffy” nose and has gradually begun to expectorate moderate amounts of respiratory secretions. He has had an elevation of temperature of up to 101.5F, that has responded to Tylenol. Mr. K has a long history of cigarette smoking and reports drinking 5-6 beers per night. On arrival, Mr. K shows signs of respiratory compromise as manifested by use of accessory muscles of the neck. He is found to have a productive cough of thick mucus. His vital signs are: BP 124/86 HR 110bpm & regular RR 24/min Temp 101F On auscultation, the ED nurse elicits loud rhonchi and wheezes. The nurse notes the presence of clubbed fingers, but no cyanosis or peripheral edema is noted. A chest x-ray reveals increased pulmonary congestion in the right lower lobe but no infiltration or pleural effusion. Spirometry reveals airflow limitation with forced expiratory volume and forced vital capacity 80%. ABG test reveals: pH: 7.35 PO2: 80 PCO2: 47 HCO3: 27 Mr. K is placed on two liters of oxygen via nasal cannula and is transferred to a respiratory unit of the hospital. On arrival at the unit, he continues to cough and, at times, coughs up blood-tinged sputum. A sputum culture is ordered, and results reveal staphylococcus aureus and gram-negative bacilli. Additional lab results include WBC 14,000/mm3 and eosinophils 600/mm3. After the physical and laboratory data are reviewed, an admitting diagnosis of bronchitis is confirmed. The following are prescribed: albuterol (Proventil) 2 puffs q4h and Ipratropium bromide (Atrovent) Soln. Inh, 2.5mL nebulization q4h acetaminophen (Tylenol) 650mg PO PRN temp greater than 100F cefepime HcL (Maxipime) 1.5g IV q12h Question 11 (5 points) Considering the patient’s lifestyle factors, what education should be provided about cefepime?