Last updated on: August 18th, 2022

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Obstructive airway disease 2

A 46-year-old woman comes to the clinic because of worsening cough and chest tightness over the last four weeks. She states her symptoms are present on most days of the week, worse during the early hours of the morning, and since onset, have woken her up from sleep on four occasions. She denies any history of sputum production or fever. About a week prior to this, she completed a course of amoxicillin for a chest infection. She is also known to have asthma, diagnosed in her childhood, and has been on an as-needed albuterol inhaler; however, she has not been regular with her clinic visits. She has a 10 pack-year smoking history, but over the last 3 years, she has attempted to cut down on her smoking habit. Her temperature is 37.0 oC (98.6 oF), pulse is 96/min, respirations are 22/min and blood pressure is 120/70 mm Hg. Oxygen saturation is 97% on room air. Chest auscultation is normal, and her inhaler technique is adequate. A PA chest x-ray is normal.

What is the most appropriate next step in her management?

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