A patient comes to the ED complaining of SOB . she has a history of COPD and has been admitted 2 months ago for exacerbation of COPD . The SÓB has progressively been getting worse over the last week . A patient the following blood work results on room air : pH 7.36 PaCO2 47 mmHg PaO2 55 mmHg 87 % her breath sounds revels inspiratory crackles at the base what is your assessment of her brathing
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