Reference no: EM133645932

Question

You have a patient named J.R. who is a 43-year-old male who arrives in the Emergency Department where you work as a Nurse Practitioner with non-specific complaints but a feeling of malaise. HPI: He has been feeling poorly for a while maybe 6 months and has been feeling progressively worse. He has tolerated all the symptoms until now because he doesn't have health insurance. He started feeling fatigued after a trip home to visit his sister who lives in Columbia. They live on a farm in a rural village about 2 hours outside Bogota. Since then he developed a cough and has had repeated upper respiratory infections which he has treated with OTC medications without much success. When he gets over one cold he gets another one a couple of weeks later. He also has had frequent burping which he felt wasn't a 'big deal', but it was annoying to his wife. He has fainted a couple of times at home including today. He has been gaining weight recently but he thinks that is due to his fatigue and not getting much activity recently. He notes that he has been having some palpitations that have scared him since they take.