In a child with suspected pneumonia, what clinical sign should the nurse look for?

In a child with suspected pneumonia, one of the primary clinical signs to assess is the presence of diminished breath sounds or crackles upon auscultation. These auditory findings are indicative of fluid or inflammation in the lungs, which is characteristic of pneumonia. When air sac infections occur, such as in pneumonia, the normal airflow may be disrupted, leading to abnormal breath sounds. Diminished breath sounds can suggest areas of the lung where air entry is limited, while crackles may indicate the presence of fluid in the airways.

The other clinical signs listed, while they may be present in a child with pneumonia, are less specific to the condition. A high fever can be associated with numerous infections, not solely pneumonia. A rash on the chest does not have a direct correlation with pneumonia and may point to other infections or conditions. Extreme fatigue is a common symptom in many illnesses and does not uniquely indicate pneumonia. Thus, diminished breath sounds or crackles are the most relevant and specific clinical signs to evaluate in a child suspected of having pneumonia.