[Expert Solution]: what would the pathogenesis be for: 8 2 -…

what would the pathogenesis be for: 8 2 – year – old female who lives in a skilled nursing facility. She suffers from rheumatoid arthritis, chronic bronchitis, hypertension, and PVD . She is wheelchair – bound and tends to spend most of her days in bed. She smoked for 5 2 years but quit 1 4 years ago. She has lost 1 0 pounds in the last month and has had a productive cough for about 2 weeks with copious amounts of white to yellow mucous. In the previous 3 days, she has refused to get out of bed or eat or drink. This morning, she is confused, has a fever, and coughs continuously. The skilled nursing facility transfers her to the ER . In the ER her sputum is rust – colored. Her lung sounds are coarse rhonchi with crackles in her right middle lobe area. Her vital signs are BP 8 6 / 5 4 , HR 9 8 , RR 2 8 and temperature 1 0 2 . 4 . She is being admitted to the hospital to rule – in community – acquired PNA. In the ER the following diagnostic tests are performed, and the results are following: Chest X – ray: parenchymal infiltrates in the RML . Sputum culture and sensitivity: Streptococcus pneumoniae & RBCs present CBC: WBC = 1 3 , 0 0 0 cells / mcL  sisUpon admission to the medical – surgical unit the following orders are placed: Rocephin 1 gm IVPB daily. NS 7 5 ml / hr via peripheral IV . Regular diet, Ensure supplements between meals. Promethazine with codeine 6 . 2 5 mg / 1 0 mg PO every 4 to 6 hours PRN for severe cough. Tylenol 6 5 0 mg PO every 4 to 6 hours PRN fever > 1 0 0 . 9 . Bed / room close to the nurse station. Fitting for compression stocking Feet elevated when sitting Encourage foot flexion and extension 1 0 x per hour.