Your Patient Is a Four-Year-Old Boy with a History of Asthma

Your patient is a four-year-old boy with a history of asthma. He ran out of his inhaled bronchodilator while visiting his grandparents' farm. The patient has pale, cool, moist skin with cyanosis of his nail beds. He has audible wheezing with a respiratory rate of 18, accessory muscle use, and a heart rate of 130. He appears fatigued, he is unable to speak more than one or two words at a time, and his head bobs with each breath. Which of the following best describes this patient's respiratory status?

A) Because of decreased respiratory, cardiovascular, and stored energy reserves, the child's muscles have fatigued and he is now in respiratory failure.
B) The child is in the early stages of his asthma attack, and is showing signs of respiratory distress.
C) The patient is having some respiratory difficulty; however, a nebulizer treatment will likely correct all issues.
D) The child's asthma was exacerbated by exercise and he is therefore tired. Rest will ease his respiratory distress.