A parent rushes their 3-year-old child to the emergency department with an asthma exacerbation. Which additional finding should alert the nurse that the child is in acute respiratory distress?

Choice A reason: Diaphragmatic respirations are normal in children; they don’t indicate distress in asthma unless accessory muscle use or retractions accompany, which aren’t specified here. Choice B reason: Bilateral bronchial sounds suggest airway consolidation, not typical in asthma; distress shows via effort signs, not just breath sound location, making this less acute. Choice C reason: Nasal flaring indicates increased respiratory effort in asthma, a clear sign of acute distress as the child struggles to breathe against airway obstruction. Choice D reason: A rate of 35 breaths/minute is elevated but within a toddler’s normal range (20-40); it’s less specific for distress than flaring in an asthma exacerbation.