[Solved]: D.Z., a 65-year-old man, is admitted to a medical floor

D.Z., a 65-year-old man, is admitted to a medical floor for exacerbation of his chronic obstructive pul- monary disease (COPD; emphysema). He has a past medical history of hypertension, which has been well controlled by enalapril (Vasotec) for the past 6 years, has had pneumonia yearly for the past 3 years, and has been a 2-pack-a-day smoker for 38 years. He appears as a cachectic man who is experiencing difficulty breathing at rest. He reports cough productive of thick yellow-green sputum. D.Z. seems irri- table and anxious; he complains of sleeping poorly and states that lately feels tired most of the time. His vital signs (VS) are 162/84, 124, 36, 102 deg F, SaO2 88%. His admitting diagnosis is an acute exacerbation of chronic emphysema.