Certified Pediatric Nurse (CPN)

What symptom indicates that a child with cystic fibrosis is experiencing acute respiratory distress?

1. Barrel-shaped chest

2. Clubbing of the toes

3. Intercostal retractions

4. Breathing after each sentence

The correct answer is: Intercostal retractions

The indication of acute respiratory distress in a child with cystic fibrosis is characterized by intercostal retractions. This symptom occurs when the muscles between the ribs (intercostal muscles) are being used more forcefully to assist with breathing due to an obstruction or increased resistance in the airways, which is common in cystic fibrosis. These retractions demonstrate that the child is struggling to breathe and may also reflect a decreased oxygen supply or increased work of breathing. Symptoms like a barrel-shaped chest or clubbing of the toes are associated with chronic changes in lung structure and function over time but do not indicate an acute situation. Breathing after each sentence suggests shortness of breath but may not specifically reflect the grave status of acute respiratory distress as clearly as intercostal retractions do. In contrast, intercostal retractions are a direct, observable sign that the child is experiencing a significant respiratory challenge, underscoring the urgency of their respiratory distress.