QLexNursing

🟦 Obtain a sputum culture (FIRST)

🟦 In a client with suspected bacterial pneumonia, it is essential to obtain a sputum culture before starting antibiotic therapy, because antibiotics can alter or reduce the number of organisms present in the sample.

🟦 Collecting the sputum culture first allows the laboratory to identify the causative organism and determine its antibiotic sensitivity, which supports targeted and effective treatment.

🟦 If antibiotics are administered before the culture is obtained, the results may be inconclusive or falsely negative, complicating the diagnosis and delaying optimal therapy.

🟦 From a priority and sequencing standpoint, this respects the principle of “culture before antibiotics” whenever infection is suspected and time allows.

🟦 This step also aligns with safe practice and antimicrobial stewardship by helping avoid unnecessary broad-spectrum antibiotic use.

🟦 Therefore, obtaining the sputum culture is the most appropriate first action to guide and individualize the client’s pneumonia treatment.

🟦 Administer antibiotic therapy (SECOND)

🟦 Once the sputum culture has been obtained, the nurse should promptly administer antibiotic therapy to treat the suspected bacterial infection.

🟦 Timely administration of antibiotics is crucial in pneumonia because delayed treatment can lead to worsening infection, sepsis, and respiratory failure.

🟦 Prescribers typically order broad-spectrum antibiotics initially, then narrow coverage based on culture and sensitivity results.

🟦 Giving the antibiotic after culture collection maintains both diagnostic accuracy and rapid therapeutic response, which is critical in acutely ill clients.

🟦 This sequence balances the need for accurate organism identification with the urgency of starting treatment.

🟦 Thus, antibiotic therapy appropriately follows sputum culture collection as the next high-priority intervention.

❌ Why the Other Options Are NOT First or Second

❌ Administer antibiotic therapy (as FIRST choice)

❌ Administering antibiotics before obtaining a sputum culture can interfere with test accuracy and obscure the causative organism.

❌ Although antibiotics are urgent, they are best given immediately after cultures are obtained, not before.

❌ Provide an expectorant medication

❌ Expectorants may help mobilize secretions but are not the first priority in suspected pneumonia.

❌ They do not treat the underlying bacterial infection or provide diagnostic information.

❌ Give an antipyretic medication

❌ Antipyretics treat fever, which is a symptom, not the cause of pneumonia.

❌ While helpful for comfort, they do not address the infection or assist in identifying the organism.

❌ Send client for a chest x-ray

❌ A chest x-ray is very useful to confirm pneumonia, but it does not necessarily need to precede sputum collection, and it does not replace the need for culture.

❌ It shows infiltrates or consolidation but cannot identify the specific pathogen or guide targeted antibiotic therapy.

❌ Draw a complete blood count (CBC)

❌ A CBC may show elevated white blood cells, supporting infection, but it is nonspecific and does not identify the organism.

❌ It is important, but it does not directly determine antibiotic choice like a sputum culture does.