NURS-60506: Comprehensive Study A 78 year old

NURS-60506: Comprehensive Study A 78 year old male presents to your office with c/o 1 week of “cold” symptoms with cough. 2 days ago he noticed bloody sputum. He tried taking an OTC cough medication with little effect. This morning he noticed some CP when he exerted himself that lasted for about 30 seconds. He has had similar pains in the past. He admits to having bloody stool with diarrhea as well for the past month but thought it would go away on its own. He has no abdominal pain, N/V, dizziness, or HA. No recent travel. He has been visiting his wife regularly in the Nursing Home 2-3x/week. Physical exam findings are as follows: VS-BP—90/54, P-130 irregular, Temp-101.2 F , Resp—32 Neck: Mildly elevated JVD Lungs: Expiratory wheezing bilaterally CV: Irregular, S1 and S2 with a III/VI systolic ejection murmur Abdomen: Tender to LLQ, BS +X4, soft, non-distended Ext: Trace pedal edema, +2PPP bilaterally Skin: Pale, cool, clammy Guaiac positive No recent labs PMH: HTN, CAD w/CABG x 2 (5 years ago), COPD, Hyperlipidemia PSH: Appendectomy in 1980 Meds: Lisinopril 10mg daily, Metoprolol 25mg BID, ASA 325mg daily, Simvastatin 80mg daily, Albuterol PRN, Spiriva 18mcg daily Social: No alcohol or drug use. He is an ex-smoker for last 5 years, prior was a pack a day smoker x 50yrs 1. What are your differential diagnoses and why did you choose each one? Please list at least 5 differentials. (10 points) 2. What lab and diagnostic tests would you order and why? (12 points) 3. What is your follow-up going to include with this patient? (8 points) SCIENCE HEALTH SCIENCE NURSING NURS 60506

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