Which of the following describes signs of respiratory distress?

• A. Blue lips and coughing only.
• B. Normal breathing with no effort.
• C. Fever and dehydration.
• D. Accessory muscle use, rapid breathing, tripod.

Answer: (D)

Signs of respiratory distress come from the body working harder to breathe. The most telling clues are increased work of breathing with visible effort, use of accessory muscles in the neck and chest, and a position that helps breathing such as sitting up and leaning forward (tripod). Rapid breathing is common as the patient tries to ventilate faster to meet oxygen needs. Together, these signs show the active struggle to ventilate. Other options don’t fit as neatly because they either show no increased effort (normal breathing) or point to other problems (fever and dehydration), or describe cyanosis without the accompanying work of breathing that indicates distress.