A 42-year-old male patient with a history of poorly controll…

A 42-year-old male patient with a history of poorly controlled asthma is seen in the emergency department by the respiratory therapist (RT). The patient is seated in a chair and clearly is in extreme respiratory distress, with inspiratory and expiratory wheezing throughout. He reports that he has had a fever for the past 2 days and has eaten and drunk very little. He also reports some chest pain, and his blood pressure is 95/55 mm Hg. At one point, the patient stands to move from the chair to the stretcher and has an episode of syncope. The differential diagnosis for this patient should include which of the following? 1. Myocardial infarction (MI) 2. Acute asthma exacerbation 3. Dehydration 4. Cerebrovascular accident (CVA; stroke)

A respiratory therapist is examining a patient in respirator…

A respiratory therapist is examining a patient in respiratory distress. She observes that the patient has a barrel chest, is using his accessory muscles of inspiration even when sitting at rest, and has a prolonged expiratory phase with pursed-lip breathing. This finding is most consistent with: