Case One - Diagnosis

Patient Chart

History

JV is a 61-year-old male who has presented to the emergency department with a chief complaint of shortness of breath that has gotten progressively worse over the past day or so. He has a history of COPD and was discharged from the hospital just two months ago.<br/><br/> Assessment in the ED reveals the following: respiratory rate 32 and slightly labored, temperature 98.8F F, SpO2 (on room air) 86%. He is alert and oriented; he has an occasional nonproductive cough. Continue the exam using the auscultation and blood pressure tab.

Based on the above data, which of the following is the next best step?