<s>[INST] hello , hi my grandmother is 70+ years of age & for the past 5 days she has been sick and she has shortness of breathe when she speaks & when she walks, she has a difficult time speaking when she speaks, when she coughs it sounds like whooping cough , and she has a difficult time walking. She has been vomiting and she shakes. Has has high blood pressure , but she never was skaking before & last week tuesday she got the flu shot when she went to the doctors. [/INST] Shaking may mean rigor? Obviously, she has severe breathlessness - Why?  It may be a reaction to the flu shot - asthma? It may be heart failure precipitated by blood pressure, in this stress of fever.  The picture sounds ALARM bell - she has to be seen IMMEDIATELY by a doctor. Blood counts and cardiac markers; ECG; X-ray chest and so on are a must.  No specific management is possible without clinical and lab work up. Delay may spell danger. Take tarnishing her speedy recovery Good luck </s>