Certified Pediatric Nurse (CPN)

Which of the following symptoms would indicate that a child with cystic fibrosis is experiencing acute respiratory distress?

1. Barrel shaped chest

2. Clubbing of the toes

3. Intercostal retractions

4. Having to take a breath after each sentence

The correct answer is: Intercostal retractions

Cystic fibrosis is a progressive disease that primarily affects the lungs, leading to the production of thick mucus that can obstruct airways and cause respiratory complications. When a child with cystic fibrosis experiences acute respiratory distress, certain physical signs are indicative of severe respiratory trouble. Intercostal retractions occur when the muscles between the ribs pull inwards to assist with breathing, indicating that the child is working harder to breathe. This manifestation suggests that the airway is compromised and that the child is struggling to obtain adequate oxygen, which aligns with the concept of acute respiratory distress. In contrast, a barrel-shaped chest and clubbing of the toes typically reflect chronic changes associated with long-term respiratory issues rather than acute episodes of distress. A child needing to take a breath after each sentence may show a sign of respiratory distress as well but does not specifically indicate the intense physical struggle to breathe that intercostal retractions do. Therefore, intercostal retractions are a more direct symptom of acute respiratory distress in this context.