Chest and Lungs

Initial observation of the quiet infant should include assessment of respiratory rate and effort. Skin retraction between the ribs during inspiration is abnormal and usually indicates respiratory distress. The abdomen may move with each breath, but it should appear effortless. Breath sounds should be equal and clear in all lung fields. Fine crackles (wet lungs) can be normal, particularly in the infant who was delivered by cesarean section, as the infant is trying to clear the interstitial fluid left over from intrauterine life. This can also be associated with a transient tachypnea that resolves spontaneously.

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