Final answer:
The child's decreased respiratory rate, lethargy, and subcostal retractions indicate worsening respiratory distress, potentially due to conditions like Respiratory Distress Syndrome (RDS) or pneumonia. A normal respiratory rate for a 1-year-old is 30-60 breaths per minute, so the decrease to 30 could signify respiratory failure. Immediate medical evaluation and intervention are necessary.
Step-by-step explanation:
The change in the child's respiratory rate from 65 to 30 breaths per minute, combined with increased lethargy and severe subcostal retractions, suggests a possible worsening of the child's respiratory condition. A normal respiratory rate for a 1-year-old should be between 30 to 60 breaths per minute. The child's initial respiratory rate of 65 was already higher than normal, indicating respiratory distress. The subsequent decrease in respiratory rate below the normal range, instead of indicating improvement, could mean the child is tiring out or that the respiratory system is failing to meet the body's oxygen needs, potentially resulting in hypoxemia or respiratory failure.
Considering the patient's age and symptoms, this could be a case of Respiratory Distress Syndrome (RDS) or another serious respiratory condition. RDS typically occurs in prematurely born infants due to insufficient pulmonary surfactant, leading to difficulties in proper lung inflation and gas exchange. Even though the subject is 1 year old, the symptoms are consistent with conditions that involve respiratory compromise. The presence of severe subcostal retractions indicates that the child is exerting extra effort to breathe, a sign commonly associated with conditions like RDS or pneumonia. Furthermore, a declining heart rate in the context of respiratory distress is concerning and warrants immediate medical intervention.
According to the Apgar score, which assesses respiration, heart rate, and other vital signs at birth, scores lower than 7 at the 5-minute mark suggest the need for medical assistance, and below 5 indicate an emergency situation. While the Apgar score is specifically used right after birth, the principles behind it apply to the evaluation of a child's condition at any age when respiratory or cardiovascular distress is present.