Which of the following is NOT an early sign of respiratory distress in pediatric patients?

Cyanosis is not typically considered an early sign of respiratory distress in pediatric patients. Rather, it is often a later sign that indicates significant hypoxia or inadequate oxygenation. Early signs of respiratory distress tend to include changes that can be noted before cyanosis develops. These might include increased heart rate, which reflects the body's effort to compensate for decreased oxygen levels; altered mental status, which can indicate difficulty in oxygen delivery to the brain; and increased work of breathing, characterized by labored or abnormal breathing patterns. When cyanosis does occur, it generally signifies that the child has progressed to a more severe level of respiratory distress, where immediate intervention is often required to improve oxygenation.