Certified Pediatric Emergency Nurse (CPEN) Practice Exam 2025 - Free CPEN Practice Questions and Study Guide

Intercostal retractions are a common early sign of respiratory distress in children. This occurs when the muscles between the ribs pull inward during inhalation, indicating that the child is working harder to breathe. It suggests that there is an increased demand for oxygen or that the patient may be facing some form of obstruction or respiratory issue.

In children, the ability to compensate for respiratory distress is often limited, making early recognition of these signs crucial for timely intervention. Other signs of respiratory distress may include nasal flaring, grunting, or rapid breathing, all of which indicate that the respiratory system is struggling.

Increased appetite and decreased heart rate are not signs typically associated with respiratory distress; rather, a child in distress may show a decrease in appetite due to fatigue or illness and an increased heart rate as a compensatory mechanism. Mild cyanosis of the extremities can occur but is usually a later sign, indicating more significant hypoxia. Thus, intercostal retractions provide clear evidence of respiratory difficulty and warrant prompt evaluation and intervention.