T.A., a 54‐year‐old Hispanic man, presented to the emergency…
Questions
T.A., а 54‐yeаr‐оld Hispаnic man, presented tо the emergency department with shоrtness of breath, fever, and a cough that has lasted several days. T.A. is being admitted to the medical unit for treatment of pneumonia and hyperglycemia. He has a history of hypertension and type 2 diabetes (T2DM). He has been taking the following medications: • Metformin 500 mg PO BID; last dose last night • Lisinopril 20 mg PO daily; last dose yesterday morning Subjective Data • Reports that his home glucometer was lost recently. • Reports frequent urination and thirst. • Smokes one pack of cigarettes a day. • Has sharp pain in the right lower chest upon inspiration. Rates pain as a 6 on a scale of 1 to 10. Objective Data Physical Examination • Temperature 38.5˚C, pulse 118, respirations 26, blood pressure 136/92 • Oxygen saturation 91% on room air • Awake and alert, oriented x 4 • Weight 86 KG • Respirations symmetrical, slightly labored on any exertion, coarse crackles right lower lobes • Cough productive of thick yellow sputum Diagnostic Studies • Lab values • Glucose 788 mg/dL • ABG‐ Ph 7.36, CO2 35, HCO3 18 • Hemoglobin A1C 9.2% • NA 150 (135‐145 meq/L), K 5.4 (3.5‐5.2 meq/L), Cl 110 (96‐106 meq/L), Mag 1.5 (1.7‐2.2 mg/dl) • Chest radiography: infiltrates‐ right lower lobe Which of the following orders will you implement? Choose ALL that apply.