An adult patient with a history of allergies comes to the clinic complaining of wheezing and difficulty in breathing when working in his yard. The assessment findings include tachypnea, the use of accessory neck muscles, prolonged expiration, intercostal retractions, decreased breath sounds, and expiratory wheezes. What do these findings suggest?

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Asthma is allergic hypersensitivity to certain inhaled particles that produces inflammation and a reaction of bronchospasm, which increases airway resistance, especially during expiration. An increased respiratory rate, the use of accessory muscles, a retraction of the intercostal muscles, prolonged expiration, decreased breath sounds, and expiratory wheezing are all characteristics of asthma. Atelectasis presents with decreased or absent breath sounds but no prolonged expiration or expiratory wheezing. Lobar pneumonia presents with tachycardia and loud bronchial breathing with patent bronchus but no prolonged expiration or expiratory wheezing. Heart failure can present with both crackles and wheezing but does not have a prolonged expiration, and based on this patient's history of allergies and the symptoms occurred when he was working in the yard, asthma is the most likely problem.

An Adult Patient with a History of Allergies Comes to the Clinic