What are some indicators of potential respiratory failure in a child?

Cyanosis and severe retractions are significant indicators of potential respiratory failure in a child. Cyanosis refers to a bluish discoloration of the skin, particularly evident in areas such as the lips and nail beds, which indicates inadequate oxygenation of the blood. This can signify that the child is not getting enough oxygen and may be in distress. Severe retractions occur when muscles between the ribs, above the collarbone, or at the base of the neck are pulled inward during breathing, indicating increased effort to breathe. These physical signs help to identify that the child may be struggling with adequate ventilation and could be at risk for respiratory failure.

In contrast, the other answer choices present symptoms that do not specifically correlate with respiratory failure. A rapid heart rate might suggest increased stress or distress but is not a definitive sign of respiratory compromise. Insomnia can be related to many factors, including anxiety, but does not indicate respiratory failure. Frequent urination and fatigue may be suggestive of other medical issues or dehydration but do not directly relate to the function of the respiratory system. Hives and coughing spells may indicate an allergic response or asthma but do not specifically reflect the state of respiratory failure as indicated by cyanosis and severe retractions.