The nurse is performing a newborn assessment. Which symptom, if present in a newborn, would indicate respiratory distress?

A. Respiratory rate of 50 breaths/minute: A normal newborn respiratory rate ranges from 30 to 60 breaths per minute. A rate of 50 falls within this normal range and, by itself, does not indicate respiratory distress. Assessment must consider other signs such as work of breathing, color, and use of accessory muscles to determine if the newborn is compromised. B. Flaring of the nares: Nasal flaring is a compensatory mechanism in newborns to increase airway diameter and reduce resistance during inspiration. Its presence indicates increased work of breathing and is an early sign of respiratory distress. Persistent flaring, accompanied by grunting or retractions, signals the newborn is struggling to maintain adequate oxygenation. C. Abdominal breathing with synchronous chest movement: Synchronous abdominal and chest movement reflects normal neonatal breathing mechanics. Newborns typically use diaphragmatic (abdominal) breathing, and coordinated chest and abdominal movement suggests effective ventilation without distress. This pattern is expected. D. Shallow and irregular respirations: Mild irregularity and periodic shallow breaths are common in healthy newborns, particularly in the first few hours after birth. Irregular breathing in this context is usually physiological and self-limited, unlike labored or retracted breathing which indicates distress.