A 35-year-old woman presents to the office for 6 months of lesions as shown on her knees and elbows. Treatment is initiated, and three weeks later, the patient presents to the emergency department with fatigue, headache, and shortness of breath. Which of the following is the next best step in the management of this patient?

A. Initiate methylene blue therapy

B. Obtain chest x-ray

C. Provide supplemental oxygen

D. Start intravenous fluids

E. Transfuse fresh frozen plasma

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