Which manifestation should be included as an exacerbation of asthma in a school-age child?

The exacerbation of asthma in a school-age child is characterized by specific signs and symptoms related to the underlying airway inflammation and bronchoconstriction that occur during an asthma attack. Wheezing and shortness of breath are classic manifestations of asthma exacerbations, as the narrowing of the airways leads to these specific respiratory difficulties.

A hacking, non-productive cough can occur in various conditions, but it is not necessarily a hallmark of an asthma exacerbation. Instead, a cough that is associated with asthma is typically more pronounced, can be accompanied by wheezing, and is often worse at night or early morning.

Chest pain during exercise, while it may be concerning, is not a direct symptom of asthma exacerbation itself. Rather, it would generally signal a need for evaluation of other potential causes for the discomfort that can occur during physical exertion.

Frequent nocturnal awakenings are significant in the context of asthma because they may indicate poorly controlled asthma. Children with asthma often experience nighttime symptoms due to nighttime airway inflammation, so this is a critical component to understand in the management of the condition.

Thus, the most characteristic manifestation of an exacerbation of asthma in a school-age child notably includes wheezing and shortness of breath, as these directly reflect