An elderly male complains of difficulty breathing that has worsened over the past two weeks. He is breathing through pursed lips and is on home oxygen at 2 lpm. What should you administer?

In this scenario, the key is to consider the patient's symptoms and the underlying conditions that may cause such respiratory distress. The elderly male is exhibiting difficulty breathing and pursed lip breathing, which suggests he may have a chronic obstructive pulmonary disease (COPD) or a similar respiratory issue. Nebulized albuterol is a bronchodilator that is commonly used to relieve bronchospasm in conditions like asthma and COPD.

Albuterol works by relaxing the muscles of the airways, increasing airflow and ultimately assisting with the patient's difficulty in breathing. In this case, administering nebulized albuterol can help alleviate bronchoconstriction and promote easier breathing, making it a suitable choice for calming the acute respiratory distress seen in this patient.

While bronchodilators via MDI and CPAP are also effective treatments for respiratory issues, nebulized albuterol is specifically beneficial for immediate relief from bronchospasm, especially for patients with worsening symptoms over a period and who may require a more intensive form of medication delivery. Intravenous fluids would not address the respiratory distress directly and are not indicated in the context of the symptoms presented.