Question

5 yo

Hx: 4 days of high fever and cough
Assessment: increased lethargy, grunting, and sleepiness, difficult to arouse, unresponsive to voice commands. Resp are shallow. Auscultation of lungs reveal bilateral crackles

VS: Pulse ox 72% RA, 89% of Non rebreather mask Resp: 38

Which assessment finding is consistent with respiratory failure in this child?

Answer 1

The critical findings suggestive of respiratory failure in the child are the markedly low pulse oximetry readings and symptoms of decreased consciousness, which indicate severe hypoxemia and impaired gas exchange.

Step-by-step explanation:

Respiratory failure is a severe condition where the respiratory system fails in one or both of its gas exchange functions: oxygenation and carbon dioxide elimination. In this case, the child's pulse oximetry readings are critically low. A normal pulse oximetry (SpO2) level is typically between 95-100%. The child's SpO2 of 72% indicates severe hypoxemia, which is a hallmark sign of respiratory failure.

The child's respiratory rate is elevated at 38 breaths per minute (normal is about 20-30 for a 5-year-old), suggesting an attempt by the body to compensate for hypoxemia. Additionally, the child's presentation of increased lethargy, grunting, sleepiness, and difficulty to arouse are all indicative of impaired gas exchange and decreased brain perfusion, aligning with clinical signs of respiratory failure. Bilateral crackles heard during auscultation also support the presence of a lower respiratory tract infection that can lead to or exacerbate respiratory failure.