A nurse admits a patient with community-acquired pneumonia. Which medical order should the nurse implement first?

Choice A reason: Administering cefazolin treats bacterial pneumonia but should follow sputum collection to avoid altering culture results. Antibiotics can reduce viable bacteria in sputum, leading to false-negative cultures, which delays accurate identification of the pathogen and appropriate antibiotic selection, making this a secondary priority. Choice B reason: Postural drainage and percussion aid in clearing airway secretions but are not the first priority. In community-acquired pneumonia, identifying the causative organism through sputum culture is critical to guide antibiotic therapy, ensuring effective treatment, while airway clearance is a supportive measure implemented later. Choice C reason: Obtaining a sputum culture and sensitivity first identifies the causative organism and its antibiotic susceptibility, guiding targeted therapy for community-acquired pneumonia. Early collection ensures accurate results before antibiotics alter bacterial growth, optimizing treatment outcomes and preventing resistance, making this the highest priority intervention. Choice D reason: Albuterol nebulizer treatments relieve bronchospasm and improve airflow but are not the initial priority in pneumonia. Identifying the pathogen through sputum culture takes precedence to ensure appropriate antibiotic therapy, as bronchodilators address symptoms rather than the underlying infection, making this a secondary intervention.