A nurse in a provider's office is assessing the vital signs of a 1-year-old toddler. Which of the following findings should the nurse report to the provider?

Assessment of pediatric vital signs requires comparison with normal age-specific ranges because normal values differ significantly from adults. In a 1-year-old toddler, heart rate, respiratory rate, temperature, and blood pressure must be interpreted based on developmental physiology. Respiratory status is especially important because toddlers can deteriorate quickly when respiratory compromise is present. Identifying abnormal findings early allows prompt intervention and prevention of serious complications. Rationale: A. A temperature of 37.7°C (99.9°F) is within an acceptable range for a toddler and does not indicate significant fever. Mild variations in temperature can occur due to activity, environment, or time of day. This finding alone would not require immediate provider notification unless accompanied by other concerning symptoms. B. A heart rate of 110/min is normal for a 1-year-old toddler. Typical resting heart rate for this age group ranges approximately from 90 to 150 beats per minute depending on activity and emotional state. Since this value falls within the expected range, it is not considered abnormal. C. A respiratory rate of 54/min is elevated for a toddler and should be reported because normal respiratory rate for a 1-year-old is generally about 20 to 40 breaths per minute. Tachypnea may indicate respiratory distress, infection, fever, or metabolic imbalance. Because children compensate early through respiratory changes, this abnormality requires prompt attention. D. A blood pressure of 88/42 mm Hg is within an expected range for a 1-year-old toddler. Pediatric blood pressure values are naturally lower than adult values due to smaller body size and developmental physiology. This reading does not suggest hypotension unless accompanied by signs of poor perfusion or shock.