Questions about Pneumonia

Hi, I have a case study to present and i wanted to ask anyone here if you could give me your angle on the scenario, so I know if I am on the right track or not. It is on a patient with pneumonia.

If you were getting a sputum specimen, would you get it first thing in the morning, after chest physio, before a meal or before sleeping? Woud your answer be because you wanted to prevent overnight pooling of secretions, to ensure a higher concentration of organisms, to permit expectoration of a large amount of sputum, or to reduce the risk of food particles contaminating the sputum?

If the patient had a stabbing pain over the affected lung, aggravated by her resps, would it be due to dry pleurisy, pulmonary fibrosis, sputum retention or spontaneous pneumothorax?

Which of these treatments would most likely be used to relieve patient's inspiratory pain? aspirin 600mg orally, IV 10mg hydrocortisone, tincture of benzoin inhalation, or salbutamol (ventolin) aerosol?

How can you best alleviate the patient;s pain during deep breathing and coughing exercises? Strap her chest with strips of adhesive tape? Support each side of her upper chest with both hands? Apply a binder around her chest? Place her hand against the affected side?

If the patient has very viscous and tenacious sputum, do you administer intermitten positive pressure respiration 4 hourly? Do you request a mucoytic be prescribed? Do you encourage hourly chest physio? Do you ensure a daily fluid intake of no more than 1000ml (cc)?

How can the patient most effectively expectorate her viscous secretions? Aspirate her with deep endotracheal suction? Insert a transcutaneous catheter into her trachea? Vibrate her rib-cage while she breaths out? Perform vigorous percussion over the areas of consolidation?

If the patient asks for something to relieve her productive cough, do you give her an antitussive to encourage rest? Give her nothing because the cough will subside when the sputum resolves? Give her an expectorant to stimulate a more vigorous cough? Or give her nothing because it is desireable not to suppress the cough at this stage?

With your answers can you give a rationale? I want to thank you for reading this far. I know I am asking a lot, but maybe this can be a bit of revision for you also.

Thank you, Jane