Difficulty: Medium
Average Score: 95%
Simulated
A nurse is caring for an infant who has gastroenteritis. Which of the following assessment findings should the nurse report to the provider?
Correct answer
B
Rationale
The correct answer is B. Sunken fontanels and dry mucous membranes are signs of dehydration in infants with gastroenteritis, indicating a severe fluid deficit. This finding should be reported to the provider immediately to prevent further complications. Choice A is incorrect because a 24-hour fluid deficit of 30 mL is within normal limits for an infant. Choice C indicates a mild fever and slightly elevated pulse rate, which are common in gastroenteritis and do not warrant immediate reporting. Choice D, decreased appetite and irritability, are expected symptoms of gastroenteritis and do not indicate a need for urgent intervention.