[Expert Solution]: RSC: “I’m falling apart

RSC: “I’m falling apart. I’ve been having more trouble breathing, my cough has gotten worse in the past three days and now my ankles are beginning to swell up.” J.T. is a 61 y/o man with COPD who presents to the emergency room with a three-day history of progressive dyspnea, cough, and production of clear sputum. He usually coughs only a scant amount of clear sputum daily which is worse after rising. He denies fever, chills, night sweats, muscle/joint aches, and blood in the sputum. He treated himself with albuterol MDI, but respiratory distress increased despite multiple inhalation doses.