An 18-year-old male complains of shortness of breath with a history of asthma, having self-administered two doses of his inhaler without relief. His vital signs are P 104, R 22, SpO2 91%. What should you do?

In this scenario, the 18-year-old male is experiencing shortness of breath and has a known history of asthma. Despite self-administering two doses of his inhaler, he still exhibits low oxygen saturation at 91%, along with an elevated pulse rate and respiratory rate. These signs indicate that he is likely in respiratory distress and may not be adequately ventilating or oxygenating.

Administering oxygen via a non-rebreather mask is appropriate because this method provides a high concentration of oxygen, which is crucial for a patient showing signs of hypoxia, as evidenced by his SpO2 level. The non-rebreather mask is designed to deliver oxygen effectively, maximizing the amount of oxygen that the patient can inhale, which is particularly important in cases of respiratory distress where the patient’s own oxygen levels are low.

Providing an additional dose of the inhaler may not be immediately beneficial if the patient has already used it twice without relief and there is no improvement in his condition. Encouraging fluid intake is not pertinent in this acute scenario, as it does not address the immediate need for improved oxygenation. While administering oxygen via nasal cannula would offer some benefit, it does not provide the high flow necessary for a patient in this level of distress.