Review Question - QID 216459

An 8-year-old boy with a past medical history of asthma and eczema presents to the emergency department with increased work of breathing and wheezing. He has had increasing cough, wheezing, and shortness of breath since his family adopted a cat. The patient's temperature is 98.7°F (37.1°C), blood pressure is 100/65 mmHg, pulse is 145/min, respirations are 60/min, and O2 saturation is 89%. On physical exam, there is nasal flaring, subcostal retractions, accessory muscle use, and poor aeration with minimal wheeze on pulmonary auscultation. In the emergency room, the patient is started on prednisone, continuous albuterol and ipratropium nebulizer, and placed on supplemental oxygen. Upon reassessment, he appears slightly improved with ongoing increased work of breathing. Which of the following is the most appropriate next step in management?