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September 2012, Volume 42 Number 9 , p 72 - 72


  • Vincent M. Vacca Jr., MSN, RN, CCRN


MR. W, 83, IS ADMITTED to the medical step-down unit with diverticulitis and a history of gastroesophageal reflux disease (GERD).On admission, Mr. W's vital signs are: temperature 99.2[degrees]F (37.3[degrees]C); heart rate, 102; respiratory rate, 16; SpO2, 95% on room air; and BP, 144/88. He has clear bilateral breath sounds and normal heart sounds. His comprehensive metabolic panel and complete blood cell count are within normal limits, except for a mild leukocytosis.However, the nurse who responds to Mr. W's call light finds him supine, dyspneic,tachypneic, and diaphoretic. His SpO2 is now 90% and his hospital gown is saturated with vomitus.Based on Mr. W's risk factors, including recumbent position, GERD, and vomiting, as well as the abrupt onset of symptoms with prominent dyspnea, the nurse suspects aspiration pneumonia. Aspiration pneumonia refers to the pulmonary consequences of the abnormal entry of fluid, particulate exogenous substances, or endogenous secretions into the lower

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