PMH, medications, allergies were reviewed. Physical Exam: Vital signs were reviewed. RESPIRATORY: The breath sounds are equal bilaterally with normal amplitude. There are no crackles, rubs, or wheezes. CARDIOVASCULAR: The heart sounds are normal. There are no murmurs, rubs, clicks or gallops. Impression: 1. Plan: 1. Electronically Signed: Joy Ciaccio, FNP-C NPI: 1356326920 License: NC 201272 DEA: MC0504464