Asthma in pregnancy Quiz: Ace Your Exams
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A 28-year-old woman, gravida 1 para 0, at 28 weeks of gestation, comes to the emergency department for shortness of breath. The patient has a history of asthma treated with as needed albuterol and fluticasone-salmeterol inhaler daily. She was in her usual state of health until the past week when she needed to use her albuterol multiple times a day for chest tightness and shortness of breath. Today, she has used her albuterol inhaler multiple times with only minimal improvement of her symptoms. Temperature is 37°C (98.6°F), blood pressure is 112/70 mmHg, pulse is 105/min, respiratory rate is 22/min, and oxygen saturation is 96% on 4 liters of oxygen via nasal cannula. The patient has mild accessory muscle usage and can speak only in 4-5-word sentences. Cardiopulmonary examination reveals diffuse wheezes bilaterally. Heart sounds are normal. Fetal heart tones are 150 beats per minute. The peak expiratory flow rate is 40% of the predicted value. Which of the following is the next best step in management?
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