Brandon, is a 31-year-old man who lives in a small mountain town in Colorado, is highly allergic to dust and pollen and has a history of mild asthma. Brandon's wife drove him to the emergency room when his wheezing was unresponsive to his fluticasone/salmeterol (Advair) inhaler, he was unable to lie down, and he began to use accessory muscles to breathe. Brandon is immediately started on 4 L oxygen by nasal cannula and intravenous (IV) D5W at 75 mL/hr. A set of arterial blood gases is sent to the laboratory. Brandon appears anxious and says that he is short of breath.
Vital Signs:
BP 152/84
Pulse rate 124 beats/min
Respiratory rate 42 breathes/min
Temperature 100.4°F (38°C)
Required:
a. Are B.T.'s vital signs acceptable?
b. What is the rationale for immediately starting B.T. on O2?
c. Keeping in mind B.T.'s health history and presenting complaint, what are the critical areas you need to evaluate during your physical assessment?