Problem: Chief complaint: " I am having difficulty in breathing" Past Medical history Patient states that he was diagnosed with COPD and high blood pressure 15years ao. Patient uses inhaler bronchodilators to treat the conditions and has worsened over time declining his respiratory conditions. Mr. Vu is allergic to pollen, which cause teary eyes, sinus congestion, and asthma symptoms. Mr. Vu TB test was negative, which was done two weeks ago. Mr. Vu reports that all his vaccines are up to date. Patient states he had his pneumococcal vaccine a year ago. Patient denies any cardiac/pulmonary procedures or surgeries performed in past. Lifestyle and personal Mr. Vu has a 20 pack-year history of smoking, continues to smoke, and has diagnosis of COPD for 15 years. Mr. Vu denies engaging in any form of exercise. Mr. Vu denies using any inhaled recreational drugs. Environmental Exposure Mr. Vu denies any exposure to chemical substance or irritants. Mr. Vu denied any recent travel outside of the county. what do i write in findings