Medical history of diabetes mellitus on insulin

Pamela Knight is a 69-year-old female with a past medical history of diabetes mellitus on insulin, hypertension, COPD, reformed tobacco user, and hyperlipidemia, who presents to urgent care today for an evaluation of productive cough, weakness, fatigue, and decrease in appetite that has been present for the past 2 to 3 days. She states that she has been feeling well until she started coughing up yellowish-green sputum.

She occasionally has shortness of breath and has been using her rescue inhaler more frequently than normal. She went to work this morning at the library and decided to come in for evaluation after the end of her shift.

Vital signs: Temperature: 99.6, HR 96, RR: 22, O2: 93%, BP: 139/72

You are the provider entering the room for examination.

What is your next step?

What other information do you need?

What 3 differential diagnoses would be a part of your work up?

How would you treat this patient as she walks out of your clinic today?