RR is 48-year-old Hispanic woman who comes to see you at the V. A. homeless clinic. The major complaint is a six-day history of worsening

RR is 48-year-old Hispanic woman who comes to see you at the V. A. homeless clinic. The major complaint is a six-day history of worsening cough, productive of green sputum. There have been fever and chills with complaints of pain in the right mid-back with deep breathing or coughing. Further history reveals a history of tobacco use of one pack of cigarettes a day for 30 years. There is an incontainent health history as a result of Post Traumatic Stress Disorder (PTSD) and homelessness. On examination, the skin is warm and clammy, pale; RR appears to not feel well; the temperature is 100.5° F; respiratory rate is 24 breaths per minute; pulse is 98 beats per minute; blood pressure is 120/75 mm Hg; and saturation of oxygen is 96 percent on room air by pulse oximetry. Auscultation of the lungs reveals rales in the right lower-posterior lung field. The remainder of the examination is within normal limits.

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