A nurse is caring for a 2-year-old child in an acute care setting. Which of the following vital signs require immediate notification to a primary care provider?

Rationale: A. BP 90/52 mm Hg, heart rate 120/min, respirations 28/min, and axillary temperature of 37.3° C (99.1° F): These vital signs are within normal limits for a 2-year-old. Blood pressure, heart rate, and respiratory rate fall within expected pediatric ranges, and the temperature is not indicative of significant fever, so immediate notification is not required. B. BP 79/40 mm Hg, heart rate 135/min, respirations 32/min, and oral temperature of 38° C (100.4° F): The blood pressure is below the expected range for a 2-year-old and may indicate hypotension, which can signal shock or severe illness. Combined with a mildly elevated heart rate and fever, these findings require immediate notification to the primary care provider. C. BP 88/45 mm Hg, heart rate 113/min, respirations 28/min, and oral temperature 37.6° C (99.7° F): These vital signs are slightly low-normal for blood pressure but remain within acceptable pediatric ranges. Heart rate and respirations are appropriate for age, and temperature is only mildly elevated, so urgent notification is not indicated. D. BP 85/50 mm Hg, heart rate 95/min, respirations 26/min, and axillary temperature of 36.7° C (98.1° F): Although the blood pressure is on the lower side of normal, heart rate and respiratory rate are within normal limits, and temperature is normal. These findings do not necessitate immediate notification but should be monitored closely.