COPD, hypertension, heart failure, benign prostatic hyperplasia. No history of allergies.

 Metoprolol (Toprol XL) 50 mg daily PO, furosemide 20 mg PO daily, finasteride (Proscar) 5

mg/day PO,Advair inhaler (fluticasone and salmeterol) 2 puffs twice daily, and albuterol inhaler 2 puffs
every 4hr PRN.

 Uses O2 @ 3L/min via nasal cannula at home for the past 10 years.

 States he usually manages his COPD well with the Advair inhaler and occasional use of the
albuterol inhaler. He thinks he caught a cold from his granddaughter last week. Increasing difficulty
breathing, even with albuterol. Has a history of 30 pack-years of smoking, quitting 5 years ago.

 Eating and drinking very little over past 2 to 3 days.

 Voiding small amounts of dark, concentrated urine (mostly at night).

 At present, cannot walk 100 feet without feeling short of breath. Cannot walk up 1 flight of stairs
(21 steps) to get in or out of his apartment without stopping to catch his breath.

 Difficulty sleeping. Last night he slept upright in his recliner.

 Denies any pain associated with shortness of breath. Feels slightly irritable because of lack of sleep.

 Does not know how he will manage to get groceries or clean his apartment. His daughter lives an
hour away and has 3 children in school.