Which finding is considered an ominous sign for asthma prognosis?

• A. Cyanosis
• B. Wheezing
• C. Tachypnea
• D. Productive cough

Answer: (A)

Cyanosis signals significant hypoxemia and respiratory muscle fatigue during an asthma flare, indicating that oxygenation is failing despite treatment. It’s a late, ominous sign that the patient may be progressing toward respiratory failure and needs urgent reassessment and escalation of care.

Wheezing is common during an asthma attack and reflects airway constriction, but it isn’t by itself a definitive indicator of prognosis. Severe obstruction can sometimes present with reduced or absent sounds ("silent chest"), which is more concerning but not shown here. Tachypnea shows distress and increased work of breathing, yet it’s not as specific or ominous for prognosis as cyanosis. A productive cough is not typical of asthma and points more toward infection or another process rather than a marker of asthma severity.