Passage / Scenario

Admitted with reports of shortness of breath and productive cough. States has been feeling tired and weak for 2 days. Parents state adolescent has not eaten in 2 days and has had low-grade fever since yesterday. Reports headache and chest discomfort as a 4 on a scale of 0 to 10. Adolescent reports not having an appetite. Breath sounds with crackles in bilaterally upper lobes. Productive cough with white sputum and dyspnea observed. Blood pressure 92/50 mm/Hg, Apical pulse rate 108/min, Respiratory rate 28/min, Temperature 39.1° C (102.4°F), Oxygen saturation 94% on room air. Chest x-ray: Small infiltrates with minimal lobar consolidation; pneumonia. WBC count 12,500/mm3, Hgb 11 g/dL, Hct 32%, BUN 22 mg/dL, Sodium 148 mEq/L, Potassium 4.1 mEq/L.