A 95 year old female with complaints of fever, cough and shortness of breath

A 95 year old female came yesterday to our casuality with chief complaints of fever since 3 days, cough, shortness of breath since 3 days, altered sensorium with loss is speech since yesterday afternoon 2 pm for an half an hour, but now resolved.

Patient was apparently asymptomatic 3 days back,then she developed fever which was high grade associated with chills ,sob since three days which was of grade 4,no complaints of pedal oedema and decreased urine output.

Not a k/c/o dm,htn,asthma,epilepsy,cva,cad

On examination,

Pr-98/min

Temp-afebrile

Rr-19/min

Spo2-92% at ra

Cvs-s1,s 2  heard

Resp-BAE +, crepts present in right infra axillary area

Abdomen-nad

Cns-conscious now,

Speech-normal

No signs of meningeal irritation

Diagnosis-

Right lower lobe pneumonia ,secondary to CAP,covid 19, with ?Cardiovascular attack(ischaemic stroke)

Plan of care-

Inj.augmentin 1.2gm/IV/bd

Inj.pan 40 mg/IV/od

IV fluids NS,RL @ 75 ml/hr

Inj.optineuron 1 amp in IV/od

Syr.ascoryl 5ml po/tid

Oxygen inhalation if SPO2 less than 90%