Affected person Amanda Smith, a 69-year-old Black feminine, presents with a continuing cough that started 5 days in the past and has since change into productive of frothy sputum. She is experiencing shortness of breath at the moment, and her temperature is 101.4°F. She has a historical past of managed hypertension for 4 years and takes HCTZ 25mg each day. She is a former smoker, give up 5 years in the past after smoking a pack a day for 15 years. She has no historical past of alcohol or drug use and attends church often. On bodily examination, she is alert however in delicate respiratory misery with a labored respiratory fee of 30 breaths per minute and tripod respiration. Her pores and skin is dry and scaly, and he or she has +1 edema in her toes to ankle degree. Her coronary heart fee is common at 110 bpm, and he or she has no murmurs or further sounds. The lungs have regular breath sounds with out crackles, bronchophony, or egophony. A differential analysis contains CAP, acute bronchitis, congestive coronary heart failure, and influenza. The plan is to switch the affected person to an acute care setting for additional work-up.