A 72-year-old male presents with a 5-day history of dyspnea which worsens with exertion, productive cough of white sputum which has increased, wheezing, decreased appetite, and fatigue. He denies fever or other URI symptoms. He smokes 0.5 ppd but hasn’t smoked much in the last few days. He has slept in the recliner for the last 2 nights. Medications: Spiriva one puff daily, losartan/hctz 100mg/25 mg qd, and omeprazole 20mg qd. He has done his albuterol nebulizer treatments about 4 times/day with mild improvement. He has also tried taking some Mucinex with mild relief. Allergy: PCN unsure of the reaction. He has not had his flu vaccine yet this year or bivalent COVID booster. He is married to his wife of 48 yrs and they have 3 children and 5 grandchildren. Vitals: temp 98.6, pulse 92, resp 26, b/p 142/80, O2 89-90% on RA.