Bronchiolitis Quiz: Ace Your Exams

A 5-month-old infant is brought to the primary care office by his parents to be evaluated for coughing and “heavy” breathing. The patient had a fever of 101.4°F three days ago, followed by clear rhinorrhea and cough, but today his breathing seems faster to his parents. He has been nursing normally and has at least 6 wet diapers per day. His 4-year-old sister has had a cold since last week. The patient was born at 41 weeks gestation, weighing 8 pounds, 2 ounces, and has no chronic medical conditions. He has never had wheezing before. Temperature is 37.3°C (99.1°F), pulse is 142/min, respiratory rate is 40/min, blood pressure is 84/40 mmHg, and oxygen saturation is 94% on room air. Weight is in the 75^th percentile, height is in the 70^th percentile, and head circumference is in the 80^th percentile. On physical examination, the infant is awake and alert with good tone and movement in all extremities. Mild subcostal retractions are noted. Scattered faint wheezes are noted bilaterally without focal lung findings. Which of the following is the best next step in management?