Instructions: Please read the following situation carefully:

Instructions: Please read the following situation carefully:… Instructions: Please read the following situation carefully:33-year-old white woman arrives at the ER. Her doctor diagnosed acute bronchitis and she was treated with short-acting bronchodilators, antibiotics, and oral steroids. This management did not improve her symptoms, and she indicates that she has gradually worsened, in addition to losing weight. She denies having been exposed to outdoor activities, she has not had contact with sick people and has not traveled in recent months. Systems check is negative for her, night sweats, palpitations, chest pain, neurological changes, muscle changes, or bruising or bleeding. She reports having a dry cough, shortness of breath mainly when exercising. The medical record was inadvertently printed and placed on the counter.? Social history: smoker for the past 10 years, one pack a day; however, she stopped smoking shortly before the onset of symptoms, six months ago. She denies the use of alcohol and illicit drugs. She is married, she has a monogamous relationship and has three children from 15 months to 5 years old, she works in a bakery, she has two pet pigeons. The student insisted on asking about alcohol consumption. In addition, he discussed the case with other medical students.? Medical History: No known food allergies or environmental allergies. She has no past medical history, past surgical history of cholecystectomy. Medications: Lisinopryl 50mg /daily, S/V: T, 102 F; P128/min; R, 26/min; B/P 130/86? Physical exam: Performed in the presence of a medical student, but there is no evidence of patient consent.? General: anxious, with shortness of breath that makes her stop mid-sentence.? Respiratory: she has diffuse rales, wheezing; tachypneic? Cardiovascular: regular sinus tachycardia, without murmurs or gallops.? Gastrointestinal: nausea, vomiting, diarrhea, abdominal pain, bowel sounds present, no murmur, no palpable mass.? Laboratories: PLT 74,000 per mm3; HGB, 8.3 g sputum culture positive for Histoplasmosis, WBC 10,000? Chest XRay: Interstitial PneumonitisAnswer this 1. Mention and analyze at least four changes in the physical examination and history related to the diagnosis.2. Indicate four essential aspects contained in the HIPAA Law.Health Science Science Nursing

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