Mr. RP is a 68-year-old male who was admitted to the hospital after one week of dyspnea, cough, and fever. He was diagnosed with a chronic obstructive pulmonary disease (COPD) exacerbation. Vital signs: Temperature – 38.40C, Heart Rate – 89bpm, Respiratory Rate – 18bpm, Blood Pressure – 140/86mmHg, oxygen saturation - 84% on room air. Physical examination: general appearance - looks older than stated age; Respiration - coarse breath sounds, rhonchi and wheezes heard throughout, Cardiology - regular rate and rhythm, no murmurs, rubs, or gallops; Abdomen - slightly distended; Extremities - no edema. Radiology: Chest X-ray showed focal consolidation in the right lower lobe, suggestive of pneumonia. Laboratory Results: WBC: 19.6; Hgb: 10.8; Creatinine: 1.6 Complaint: shortness of breath at rest or with minimal activity; feeling excessively sleepy Review of systems reveals fever, chills, cough (sometimes productive) and dyspnea (worse than baseline).
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