Situation: 38 year old Caucasian male presents

Situation: 38 year old Caucasian male presents to emergency room with complaints of flu like symptoms including shortness of breath, fatigue, fever, chills, and night sweats x 2weeks. Pt also complains of white patches on his tongue and ulcerations in his mouth. Pt tells ER physician he feels like he had the flu earlier this year so he doesn’t know why he has it again. During further assessment the RN noticed swollen lymph nodes in the neck, armpits, and groin. The pt tells the nurse he has lost 41lbs over the past few months and has a poor appetite. Current height 6′ 1″ current weight 137lbs. Background: Pt is married to his wife of 12 years, has 2 kids ages 11 and 8. Pt works as an over the road truck driver and is gone from home for several weeks at a time. Pt and his wife have marital difficulties related to his absence from home and infidelity. Pt refuses marital counseling related to his busy work schedule. Pt has not followed up with his primary care physician in several years for his medical conditions. Pt states he does not take his prescription medication the way it is prescribed. Pt admits to drinking alcohol on weekends but denies illicit drug use. Current Vital Signs: Home Medications: Oral Temp: 100.1 Lisinopril 10mg daily BP: 88/62 Albuterol 2 puffs Q4hr PRN Pulse: 103 Allopurinol 100mg daily Respirations: 24 Sertraline 200mg daily Pain: generalized 7/10 Simvastatin 10mg daily Lorazepam 4mg TID PRN Expected past medical history based on meds: Expected diagnostic tests: Expected labs to be drawn: Expected medications to given:

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