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Situation: Kevin comes in with increased WOB, cough.

And wheezing

Background: Kevin is a 35-year-old father of 2 with no history of smoking or recreational drug

usage and is a social drinker. Kevin works a desk job at the Marriott and has lived a sedentary

lifestyle and decided to get back into shape today. He was running on the treadmill when he

started to have difficulty breathing with no resolve after stopping the treadmill. Brother has

asthma.

Assessment: Kevin has no tar staining or finger clubbing and has a pounding radial pulse with a

rate of 126 bpm. Kevin has bilateral wheezes with decreased aeration, prolonged expiratory

phase and mild suprasternal retractions, decreased chest expansion, hyperresonance in all lung

fields with no tracheal deviation and reduced vocal resonance; apex beat is normal; no radio-

radial delay; no conjunctival pallor noted. O2 saturations are 89% and RR is 23 bpm. No tremors

noted. Patient is exhibiting asthma symptoms.

Recommendations. Will place the patient on oxygen, obtain a CXR and receive an albuterol

MDI. Will reassess Kevin after treatment is given. Will recommend scheduling an exercise

challenge test with PCP.

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