The nurse is completing a respiratory assessment on a newborn. What are normal findings of the assessment the nurse should document? (Select all that apply.)
a. Periodic breathing
b. Respiratory rate of 40 breaths/min
c. Wheezes on auscultation
d. Apnea lasting 25 seconds
e. Slight intercostal retractions
ANS: A, B, E
Periodic breathing is common in full-term newborns and consists of rapid, nonlabored respirations followed by pauses of less than 20 seconds. The newborn's respiratory rate is between 30 and 60 breaths/min. The ribs are flexible, and slight intercostal retractions are normal on inspiration. Periods of apnea lasting more than 20 seconds are abnormal, and wheezes should be reported.
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