A) General appearance: lethargic; frail appearance consistent with stated age; slender, with wrinkled, loose skin; inattentive to environment. Confused to place and date/time - this is unusual for JR.
b) Vital Signs: Retracting respirations of 28 breaths/min, BP is 164/96 mmHg, pulse is 120 beats/min, and temperature is 38.1C.
c) His skin is hot, dry with poor turgor, color is pale gray, his chest is barrel-shaped, and he uses accessory muscles to breathe; he appears anxious and is sitting in a tripod position. His nail beds are bluish in color; his oxygen saturation by pulse oximetry is 85%. Chest auscultation reveals wheezes and decreased-to-absent breath sounds in bilateral bases. Hyperresonance is noted upon chest wall percussion. Chest x-ray showed atelectasis bilaterally in the bases. Mr. JR has a productive cough during assessment.

Explain why the respiratory system would have the highest priority during Mr JR's physical health assessment. (150 words)