• The patient usually presents with complaints of dyspnea, cough, shortness of breath, and chest tightness.

• Because of their inability to breathe, patients are generally anxious and may be agitated. In acute severe asthma, patients may be unable to communicate in complete sentences.

• Mental status changes may indicate impending respiratory failure. Signs

• The patient usually has tachypnea and may have tachycardia.

• Wheezing may vary from end-expiratory wheezing in mild exacerbations to wheezing throughout inspiration and expiration in severe exacerbations.

• Bradycardia and absence of wheezing may indicate impending respiratory failure.

• Patients may also present with hyperinflation, use of accessory muscles to breathe, pulsus paradoxus, diaphoresis, and cyanosis.

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