What is the next step after initiating oxygen therapy in the 5-year-old patient?

After initiating oxygen therapy in a 5-year-old patient, the logical next step is to administer albuterol via small volume nebulizer. This is particularly relevant in cases where the patient may be experiencing wheezing or signs of bronchospasm, such as in asthma or reactive airway disease. Albuterol is a bronchodilator that works to relax the muscles of the airways, making it easier for the patient to breathe and improving oxygenation.

The other options, while important in certain clinical scenarios, would not follow immediately after oxygen therapy. For example, preparing for mechanical ventilation might be necessary in cases of severe respiratory failure, but it is typically a later step if the patient does not respond to initial therapies. Starting oral antibiotics is more relevant in cases where a bacterial infection is suspected, but oxygen therapy precedes the assessment for infection treatment. Ordering a chest X-ray could provide valuable information about the underlying condition but is not an immediate action that directly addresses the patient's airway and breathing problems. Therefore, administering albuterol is the most appropriate next step in managing respiratory distress in a pediatric patient following oxygen therapy.