Physical exam look for JVD, edema, etc. obtain chest xray, checking BMP, PBNPT, D Dimer if SOB was acute. Determine the onset of symptoms , what the patient was doing or alwhat they were around. Ask if they have had to change anything such as sleeping upright or with pillows, if they recently traveled . review symptoms with patient, exam lung sounds , medication list, medical history, social and family history. Check for any recent medication changes.

I would have the patient stop the medication, obtaine urine sample, Lab work for CK, BMP, hepatic function and monitor for signs of rhabdo

I would completed and physical and medical history. Review all medication patient currently is taking, obtain vitals to check blood pressure and heart rate. I would educate the patient on medication adherence and ensure he understood that he can not take any nitrates or dilators while taking sildenafil. Also ensure he is medically capable as well as cardiac stable for sexual activity

My name is Elizabeth Tolley - I graduated from Walden university with my MSN in Nursing and focus on AGACNP. I’ve taken the boards 2 times and have been 3-4 point shy of passing l. I’m hopeful that this might help trigger something while I contour to study to retake my boards