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Patient Encounter: You are lead physician assistant at the Blue Marble Medical Clinic, with authority to act as a physician. A 54 yr old white man comes to the office because of a 3-day history of worsening cough that is productive of a moderate amount of yellowish, non-bloody sputum. He says the cough causes sharp pain in the right side of chest, and the cough and pain have been causing difficulty sleeping. He has not had anything like this before. Hypertension since age 42, well-controlled on medications. Hypercholesterolemia since age 50, poorly controlled with diet. No history of COPD, asthma or other lung disease, coronary artery disease, renal disease, cancer, diabetes, or immune-suppressing disorders. Tonsillectomy age 10, ligament repair of the right knee age 26. Presently on: Chlorthalidone 25 mg once/day and enalapril 40 mg once/day for past 6 years.States: No known drug allergies. No seasonal allergies. Family history: Mother age 80 with hypertension, type 2 diabetes mellitus, and high cholesterol. Father died at age 64 of coronary artery disease (CAD). Additional info: Patient is employed as a lawyer. He plays squash vigorously twice a week, is poorly compliant with a low-fat diet, and consumes approximately 6-8 alcoholic drinks/week. He
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NURSING

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