F.F., a 68-year-old man, is admitted to a medical floor with an
acute exacerbation of chronic obstructive pulmonary disease (COPD).
His other medical history includes hypertension and type 2
diabetes. He has had pneumonia yearly for the past 3 years and has
been a two-pack-a-day smoker for 38 years. His current medications
include enalapril (Vasotec), hydrochlorothiazide, metformin
(Glucophage), and fluticasone/salmeterol (Advair). He appears a
cachectic man who is having difficulty breathing at rest. F.F.
seems irritable and anxious; he complains...