The 79-year-old patient with bacterial pneumonia becomes increasingly restless and confused. Temperature is 100° F and pulse, blood pressure, and respirations are elevated since the last assessment 6 hours ago. The initial intervention by the nurse should be to:

A. White blood cell (WBC) count, arterial blood gases (ABGs):WBC count helps assess the presence and severity of infection, while ABGs evaluate the patient’s oxygenation and gas exchange critical factors in pneumonia. These tests directly reflect respiratory function and the inflammatory response.

B. Complete blood count (CBC), urinalysis:While a CBC includes the WBC count, the rest of the values are not directly helpful in tracking pneumonia progression. A urinalysis assesses kidney and urinary tract health, not respiratory infection, so it is not essential.

C. Electrolytes, serum creatinine:These tests provide information on renal function and electrolyte balance, which may be relevant in complex cases but are not specific indicators of pneumonia status or treatment response.

D. Partial thromboplastin time (PTT), serum potassium:PTT evaluates clotting, and serum potassium assesses electrolyte balance. Neither test provides useful information about the progression or resolution of pneumonia.

A. Electrolyte levels:While important in general health assessment, electrolytes are not specific to evaluating asthma severity or lung function. They would not determine the respiratory status directly.

B. Pulmonary function test including peak flow:This is the most relevant diagnostic tool for asthma. It measures airflow limitation and helps assess the severity of the asthma exacerbation and response to treatment, guiding both immediate care and long-term management.

C. CBC:A CBC may show signs of infection or inflammation but does not assess lung function. It is not specific enough to determine the status of an asthma exacerbation or guide bronchodilator therapy.

D. Allergy skin testing:This may be done later to identify triggers in chronic asthma management, but it is not useful for acute status assessment or immediate treatment decisions.