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Mr. Zhang, a 68-year-old Chinese man C/O shortness of breath and...

Mr. Zhang, a 68-year-old Chinese man

C/O shortness of breath and fatigue.

smoked 98 pack-year history. Diagnosis high blood pressure and COPD.

Patient takes thiazide diuretic, chlorthalidone, for his high blood pressure. Albuterol and ipratropium inhalers for breathing. Allergies: pollen and latex.

History of past Illness States he has increase in shortness of breath recently. He also says he is coughing "stuff up"

Ask Mr. Zhang more OLDCARTS about his symptoms.

Vital Signs: Oral Temp 100 F, HR 112 BPM, RR 24, and BP 156/78 mm Hg, SpO2 88%

Inspection:  Anteroposterior (AP) diameter to the Transverse (T) diameter ratio is 1:1. Skin color pale, using accessory muscles to breathe. Clubbing present in fingers. Coughing up moderate amounts of thick-yellow sputum. Other inspection document as normal/expected findings

Palpation: Tactile fremitus increased right bases anteriorly and posteriorly. Document the rest of palpation as normal/expected findings

Auscultation: Crackles in right lower lobe. Positive bronchophony and whispered pectoriloquy over right lower lobe. Positive E to A change present over right lower lobe. Document rest of auscultation as "normal" What is this patient at risks for

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