A child with fever and productive cough presents with respiratory distress. Which finding is characteristic?

The presence of crackles in the right lower lobe is characteristic in this scenario, particularly given the symptoms of fever and productive cough accompanied by respiratory distress. Crackles, also known as rales, indicate the presence of fluid in the airways or alveoli, which can occur due to pneumonia or other lung infections that are often associated with cough and fever in children.

In the context of respiratory distress with fever and a productive cough, finding crackles in a specific lobe, such as the right lower lobe, suggests localized inflammation or infection, which can often lead to compromised respiratory function. Given that the child is exhibiting respiratory distress, this finding is particularly relevant as it may represent underlying pathology such as pneumonia, which would necessitate prompt assessment and management.

In contrast, generalized wheezing might suggest bronchospasm, stridor on inspiration would point toward upper airway obstruction, which is not indicated by the child's symptoms, and cyanosis of the lips would typically indicate severe hypoxia rather than being a direct finding of lung pathology. Thus, the identification of right lower lobe crackles aligns well with the clinical picture presented.