Which physical finding most directly indicates an obstructed airway in a patient with respiratory distress?

Which physical finding most directly indicates an obstructed airway in a patient with respiratory distress?

• A. Wheezing only on expiration.
• B. Retractions and nasal flaring.
• C. Clear breath sounds.
• D. Normal chest expansion.

Answer: (B)

When the airway is obstructed, the body works harder to draw air in. The clearest bedside clue is signs of increased inspiratory effort, shown by retractions and nasal flaring. Retractions reflect the use of chest wall and neck muscles to pull air in against resistance, while nasal flaring widens the nostrils to decrease airway resistance and improve airflow—both directly signal that air passage is compromised. Wheezing on expiration can occur with narrowed airways, but it is a secondary sign of airflow limitation rather than a direct measure of obstruction. Clear breath sounds and normal chest expansion suggest air is moving without marked obstruction or excessive work of breathing, so they’re not as direct indicators of an obstructed airway.

When the airway is obstructed, the body works harder to draw air in. The clearest bedside clue is signs of increased inspiratory effort, shown by retractions and nasal flaring. Retractions reflect the use of chest wall and neck muscles to pull air in against resistance, while nasal flaring widens the nostrils to decrease airway resistance and improve airflow—both directly signal that air passage is compromised.

Wheezing on expiration can occur with narrowed airways, but it is a secondary sign of airflow limitation rather than a direct measure of obstruction. Clear breath sounds and normal chest expansion suggest air is moving without marked obstruction or excessive work of breathing, so they’re not as direct indicators of an obstructed airway.