The nurse is assessing a full-term newborn's breathing pattern. Which finding should the nurse assess further?

• A. Shallow with an irregular rhythm.
• B. Chest breathing with nasal flaring.
• C. Diaphragmatic with chest retraction.
• D. Abdominal with synchronous chest movements.

Answer: (B)

Recognizing signs of respiratory distress in a term newborn is crucial, since their breathing patterns evolve as oxygenation adjusts after birth. Normal newborn respiration is largely diaphragmatic (abdominal movement) and can be irregular with brief pauses (periodic breathing). When you see chest-dominant breathing with nasal flaring, this signals that the infant is making extra effort to breathe and may be experiencing airway obstruction or hypoxemia, so it needs closer assessment. Nasal flaring reflects increased work of breathing and often accompanies tachypnea and other distress signs, prompting further evaluation of color, oxygen saturation, and overall respiratory effort. In comparison, shallow irregular breathing can be part of normal periodic breathing, and abdominal movement with synchronized chest movement is typical. If chest retractions are present with any respiratory pattern, that also indicates distress, but the combination of chest-dominant breathing and nasal flaring specifically stands out as a change from normal and warrants immediate assessment.