NORCET-7 Mains-2024: Which of the following clinical manifestations are commonly seen in a child with respiratory distress syndrom…

NORCET-7 Mains-2024

Child Health Nursing (Pediatrics)

Easy

Appeared in: NORCET-7 Mains-2024

Explanation

Dyspnoea (difficulty breathing), intercostal retractions (chest wall sinking between ribs), and nasal flaring (widening nostrils) are the classic triad of signs indicating increased work of breathing.
These signs are hallmark features of Respiratory Distress Syndrome (RDS), a condition caused by surfactant deficiency in premature infants, which makes the lungs stiff and difficult to inflate.
Each sign is a compensatory mechanism: dyspnoea and nasal flaring increase air intake, while retractions show the intense muscular effort required to breathe.
Recognizing this combination of signs is critical for the early diagnosis and management of RDS.

Option A: Bradypnoea, or slow breathing, is the opposite of the expected initial sign in RDS, which is tachypnoea (rapid breathing).
Option B: Nausea, vomiting, and malaise are general systemic or gastrointestinal symptoms and are not primary or specific signs of respiratory distress in a neonate.
Option D: Abdominal pain, constipation, and absent bowel sounds are signs related to the gastrointestinal system, not the respiratory system.

Clinical Relevance

Nursing practice connection: Use the key finding related to Clinical manifestations of Respiratory Distress Syndrome (RDS) to guide bedside assessment, documentation, and the next nursing action.
A nurse's ability to rapidly identify the signs of respiratory distress (retractions, flaring, grunting) is crucial for early intervention and preventing progression to respiratory failure.
Prompt reporting of these signs allows for timely initiation of treatments like CPAP or surfactant therapy, which dramatically improves outcomes in infants with RDS.
What if? If the infant displayed these signs along with a low body temperature, the nurse's priority would include not only respiratory support but also immediate warming measures, as hypothermia significantly increases oxygen demand and worsens respiratory distress.

How to Approach the Question

First, identify the core of the question: it asks for the common signs of Respiratory Distress Syndrome (RDS).
Recall the basic pathophysiology of RDS: it's a disease of lung immaturity (lack of surfactant) causing stiff lungs and difficulty breathing.
Think logically about what 'difficulty breathing' looks like. The body has to work harder to get air in.
Analyze the options for signs of increased 'work of breathing'.
Option C lists dyspnoea (the definition of difficult breathing), retractions (using extra muscles to pull air in), and nasal flaring (trying to make the airway bigger). These are all direct signs of increased respiratory effort.
Rule out the other options: Bradypnoea (slow breathing) is the opposite of the initial compensatory response. The other options list gastrointestinal symptoms, which are not the primary signs of a respiratory disease.

Concept Tested & Keywords

Concept Tested: Clinical manifestations of Respiratory Distress Syndrome (RDS)
Stem keywords: clinical manifestations, child, respiratory distress syndrome, RDS
Lead-in keywords: Which of the following
Clinical cues: Age/sex group narrows the expected diagnosis, intervention, or normal reference range.
Negative lead-in flag: false

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E6 Nelson Textbook of Pediatrics(2024) — Volume 1 pp. 1086-1088, 657-659