The patient complains of shortness of breath

Hospital Base Rate: 39,236.78 History of Present L. ness. The patient is a 75-, ex-Jlo sewn lo with a teri scle.- sis . te _AD status post co opay – rey ,pas. graft. CANG functioning well with no complications . stenosis. The patient complains of shortness of breat.. Wat Logan _ to 4 day prior / admission and became worse on the day . admission. the complains of whee ing and cough , rouuctive of hitish :, utum "To fever, Lills nausea, or vomiting. Paroxysm-l nocturnal dyspnea, witho, new is unchanged. Past medical history, as hysical L.camination: On physical e..amination, the patient is alert anu oriented in mild cistress. Her blood pressure is .50 70. respiratory rate .6. The temperature is afebrile. The heau and neck examinations are within normal limits. Patient wheezes. Abdomen soit, nontenuer. The extremities are 4+ edema bilaterally. Neurological: Left upper extremity and lest lower extremities were weak and the patient is unable to umbulate. Labora.ory Data: The WBC is 7.5, hemoglobin 11.0. hematocrit 34.2. The platelets are 292,00v. The digoxin level is 0.5. The chest x-ray revealed cardiomagaly anu congestive heart failure. Pulmonary vascularity within normal limits. The sodium is 143, potassium 4.5, chloride 1i1, bicarbonate 21. The BUN is 23, creatinine 1.2, glucose 207. Hospital . .se: The patient was admitted with chronic obstructive pulmonary disease e acerbation. She respunueu well to nebulized breathing treatments anu intravenous Solu-Medrol. She was then switched to oral sternids. The patient was discharged home in stable condition on the following medications Prednisone 40 mg on an untapering dose, aspirin, enteric-coated, one PO y a.m.; Atrovent and albuterol inhaler Persontine 75 my tid., Theopnylline 300 mg b.i.u: Diltiazem 90 m.g tid. Nitmpaste 7:5 mg q a m.; Lasix 40 mg qam; and digoxin 0.25 mg qa.m. She is to follow-up in 2 weeks in the pulmonary clinic. The patient also has follow-up in the carviology clinic. Filial Diagnosis: Acute exacerbation of chronic obstructive pulmonary disease. Secondary Diagnoses: Congestive heart failure, acute diastolic. Type 2 diabetes mellitus controlled by diet. Hypertension. Principal diagnosis. J44.1 Y Other diagnoses: 150.31 Y, E11.9 Y, 110 Y