A 56-year-old female pati...

A 56-year-old female patient, homemaker comes to ER with grade 4 mMRC that was progressive since the last 4 months. SOB increased in the right lateral decubitus position and was relieved with sitting up. The patient also had a dry cough during that period and on-off fevers for 1 month, low grade, not associated with chills or rigors or myalgias. The patient has diagnosed with HTN 4 years ago on Telmisartan 40mg OD, not a k/C/o Diabetes or asthma or COPD. The patient is a non-smoker but has had biomass exposure for 15 years and ongoing second-hand smoking from her husband. No contact history. Vital BP 100/60 mm Hg, PR 110/min, RR 28 cycles/min, Temp 100.2F, and Spo2 86% RA and 94% with 4L nasal prongs. How would you approach this case?