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Problem
A 53-year-old man presents to the emergency department (ED) because of increasing shortness of breath, fever up to 101.2 F, and a productive cough with a lot of greenish-yellow sputum for the past 5 days. His dyspnea is worse than usual, and he has already used his inhaler x 4 puffs today. He was diagnosed with chronic obstructive pulmonary disease (COPD) last year and uses an inhaled short-acting p-agonist as needed for symptoms, but has never been hospitalized. Since his diagnosis, he quit smoking after 35 pack-years. He works in an office. Today's vital signs are temperature 38.6 C (101.5.F), heart rate 110/min, respiratory rate 22/min, blood pressure 110/80 mm Hg, and 02 saturation 92% on room air. On examination, there are crackles and respiratory wheezes in the lower lung fields. Get the instant assignment help. His FEV, is 57% of predicted. He is given nebulized ipratropium bromide and IV glucocorticoids and observed for several hours in the ED and has improved. What other treatment should be given to him as an outpatient?
Short Paper on Cross-cultural Opportunities and Conflicts in Canada.
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