Signal Sprint 05: Not Every Wheeze Is the Same Problem

Prescribe a prednisone taper and refill albuterol based on her prior asthma diagnosis

Perform a focused cardiopulmonary examination, assess oxygen saturation trend, and obtain additional history before prescribing

Administer a nebulized albuterol treatment and reassess

Her history of mild intermittent asthma and prior albuterol use

Tachycardia, oxygen saturation of 93%, unilateral decreased breath sounds, pleuritic chest pain, right calf swelling, recent prolonged travel, and oral contraceptive use

Her subjective sense that this feels like her asthma

Respiratory rate of 22 breaths/min and tachycardia

Which combination of findings most meaningfully weakens an asthma-only explanation?

Prescribe oral steroids and a short-acting bronchodilator as requested, with follow-up if not improved in 5 days

Treat this as a potentially thromboembolic process requiring urgent evaluation beyond routine asthma management, with disposition based on hemodynamic status and available resources

Reassure her and attribute the calf swelling to prolonged sitting

Refer to pulmonology and return in 2 weeks