Which physical examination finding may indicate an asthma exacerbation?

Altered mental status can indicate an asthma exacerbation because it often reflects decreased oxygenation or increased carbon dioxide levels in the body due to severe bronchoconstriction or respiratory distress. When a patient is experiencing an asthma attack, the airflow obstruction can lead to hypoxemia, which may manifest as confusion, lethargy, or altered consciousness. Recognizing altered mental status in this context is crucial, as it suggests that the patient may be in a critical state and requires immediate intervention.

Other findings, such as clear nasal passages or the absence of accessory muscle use, do not correlate with an asthma exacerbation. Clear nasal passages typically suggest an absence of upper respiratory congestion that could contribute to wheezing or difficulty breathing. Additionally, strong, steady breath sounds might indicate that the airflow is not severely compromised; however, in an exacerbation, breath sounds may actually become decreased or abnormal due to airflow limitation. The absence of accessory muscle use is often a sign that the patient is not in severe distress and is able to breathe adequately without relying on additional muscles to aid in respiration.