An alert 7-year-old feels as if his heart is racing. His lungs are clear, but he is dyspneic. What is your initial treatment?

Administering oxygen is the appropriate initial treatment for the 7-year-old experiencing dyspnea with a sensation of a racing heart, especially since it suggests the possibility of reduced oxygenation despite clear lung sounds. In children, dyspnea can stem from a variety of causes, including anxiety, exercise, or underlying respiratory issues, and providing oxygen can help ensure adequate tissue oxygenation and ease any distress the child is feeling.

Oxygen therapy is typically prioritized in cases of dyspnea to support respiratory function and alleviate symptoms. While reassurance and monitoring are important components of managing pediatric patients, ensuring adequate oxygen levels is critical, particularly if the child is exhibiting signs of respiratory distress.

The decision to administer albuterol, a bronchodilator, may depend on a more specific diagnosis such as asthma or bronchospasm, which does not seem indicated here given the presentation. Monitoring vital signs is essential, but it does not address the immediate concern of dyspnea or potential hypoxia, making oxygen administration the most effective and immediate intervention in this scenario.