Because bacteria cause as many as 50% to 70% of CB episodes, it is important to approach older patients with CB by evaluating the severity of the exacerbation using the three cardinal symptoms of CB increased sputum volume, increased purulence, and increased dyspnea from baseline. Furthermore, consideration of underlying comorbidities, underlying severity of lung disease, and the frequency of exacerbations help determine whether the episode is an uncomplicated or moderate to severe (Lung Institute, 2016). Elderly patients are at high risk for COPD with CB and bronchiectasis. Episodes of Acute Exacerbation of COPD and Acute Exacerbation of CB are associated with viral, bacterial, and atypical organisms, along with environmental factors acting as triggers. Elderly patients also have greater risk for resistant bacterial organisms such as multiple drug–resistant S. pneumoniae, and non-enteric gram- negative organisms such as H. influenza, Stenotrophomonas, and P. aeruginosa (Albertson, Louie & Chan, 2010). Measures to Reduce Negative Side Effects To help with the negative side effects the patient may need to be admitted into a hospital setting for monitoring and observation. To help with the gastrointestinal upset or nausea and