The nurse is assessing a patient with multiple traumas, who is at risk for developing respiratory distress syndrome. What assessment finding does the nurse expect as an early sign of respiratory distress syndrome?

A. Inspiratory crackles: Crackles typically appear later in respiratory distress syndrome (RDS) due to alveolar collapse and fluid accumulation. Early in the syndrome, the alveoli are still partially functional, so crackles may not yet be present. Relying on this finding could delay recognition of the initial compromise. B. Bilateral wheezing: Wheezing results from bronchospasm or airway obstruction and is more characteristic of conditions like asthma or COPD exacerbations. It is not an early sign of RDS, which primarily involves alveolar collapse, decreased surfactant, and impaired gas exchange rather than bronchial constriction. C. Increased respiratory rate: Tachypnea is an early compensatory response to hypoxemia and carbon dioxide retention in RDS. The body attempts to maintain oxygenation and ventilation by increasing the respiratory rate before overt signs such as crackles or retractions appear, making it a key early indicator. D. Intercostal retractions: Retractions indicate increased work of breathing and usually occur later in the progression of respiratory distress. They reflect significant respiratory muscle fatigue and impending respiratory failure rather than an initial compensatory change.