Soru

A $64$-year-old man presents to the urgent care clinic due to a $3$-day history of worsening shortness of breath. He reports that his baseline chronic cough has increased in frequency, and his sputum has changed from small amounts of clear mucus to copious amounts of thick, yellow-green phlegm. The patient has a history of severe chronic obstructive pulmonary disease (COPD) and uses daily inhaled tiotropium and as-needed albuterol. He smoked a pack of cigarettes daily for $40$ years but quit $2$ years ago. His temperature is $37.3^\circ\text{C}$ ($99.1^\circ\text{F}$), blood pressure is $132/84\text{ mm Hg}$, pulse is $92/\text{min}$, and respiratory rate is $20/\text{min}$. Pulse oximetry is $94\%$ on room air. He is speaking in full sentences and is in no acute distress. Lung auscultation reveals a prolonged expiratory phase with diffuse bilateral wheezing, but no crackles are heard. Cardiovascular examination shows no jugular venous distension and no lower extremity edema. The physician administers nebulized albuterol and ipratropium and prescribes a $5$-day course of oral prednisone. Which of the following is the most appropriate additional step in management?