You are seeing an 89-year-old male who

You are seeing an 89-year-old male who has a history of smoking 2 packs of cigarettes a day for 69 years. He quit smoking cold turkey when he was 78 years old. He is in your office for a general health evaluation. He reports ongoing challenges with ‘belching’ but other than that he conveys that he is feeling pretty good. He is on no routine medications. During your interview with the patient you note that he utilizes pursed lip breathing. At times you note a faint ‘whistling’ sound associated with his respiratory effort. In conducting your review of systems he reports a cough, particularly in the mornings, productive for thick clear to white sputum. When queried about shortness of breath he does indicate that he gets SOB more easily than he used to. His breath sounds are course and diminished in the lower lobes bilaterally. Therapeutics: pharmacologic interventions, if any – include considerations for OTC agents (pharmacologic and non-pharmacologic/alternative); [optional – any other therapies in lieu of pharmacologic intervention] Educational: health information clients need in order to address their presenting problem(s); health information in support of any of the ‘therapeutics’ identified above; information about follow-up care where appropriate; provision of anticipatory guidance and counseling during the context of the office visit Consultation/Collaboration: if appropriate – collaborative ‘Advanced Care Planning’ with the patient/patient’s care giver; if appropriate -placing the patient in a Transitional Care Model for appropriate pharmacologic and non-pharmacologic care; if appropriate – consult with or referral to another provider while the patient is still in the office; Identification of any future referral you would consider making SCIENCE HEALTH SCIENCE NURSING NSG 424

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