An elderly client has been ill with the flu, experiencing headache, fever, and chills. After 3 days, she developed a cough productive of yellow sputum. The nurse auscultates her lungs and hears diffuse crackles. How would the nurse best interpret these assessment findings?
A. It is likely that the client is developing a secondary bacterial pneumonia.
B. The assessment findings are consistent with influenza and are to be expected.
C. The client is getting dehydrated and needs to increase her fluid intake to decrease secretions
D. The client has not been taking her decongestants and bronchodilators as prescribed.
Correct Answer: A. It is likely that the client is developing a secondary bacterial pneumonia.
Pneumonia is the most common complication of influenza, especially in the elderly. The development of a purulent cough and crackles may be indicative of a bacterial infection that is not consistent with a diagnosis of influenza.
Option B: Diagnosis of influenza can be reached clinically, especially during the influenza season. Most of the cases will recover without medical treatment, and they would not need a laboratory test for the diagnosis. Signs and symptoms of influenza in mild cases include a cough, fever, sore throat, myalgia, headache, runny nose, and congested eyes. A frontal or retro-orbital headache is a common presentation with selected ocular symptoms that include photophobia and pain with different qualities.
Option C: These findings are not indicative of dehydration. The clinical presentation of influenza ranges from mild to severe depending on the age, comorbidities, vaccination status, and natural immunity to the virus. Usually, patients who received the seasonal vaccine present with milder symptoms, and they are less likely to develop complications.
Option D: Decongestants and bronchodilators are not typically prescribed for the flu. Influenza infection is self-limited and mild in most healthy individuals who do not have other comorbidities. No antiviral treatment is needed during mild infections in healthy individuals. Antiviral medications can be used to treat or prevent influenza infection, especially during outbreaks in healthcare settings such as hospitals and residential institutions.
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