A nurse is caring for a client in a clinic. Exhibits Based on the information in the client's medical record, which of the following findings require immediate follow-up? Select the 4 findings that require follow-up.

A. Caregiver reporting client acting differently than usual: A change in behavior after a traumatic event can indicate a mental health concern, such as ASD, PTSD, or depression. Any significant deviation from baseline behavior in a grieving client warrants further evaluation. B. Witnessing their family's death: Direct exposure to trauma is a significant risk factor for PTSD. Witnessing the deaths of loved ones in a natural disaster is an extreme stressor that requires psychological support and intervention. C. Attends school regularly: The client’s ability to continue attending school and perform well academically suggests they still maintain some daily structure and function, which is a positive factor. This does not require immediate intervention. D. Client experiences nightmares: Recurrent distressing dreams related to the traumatic event are a hallmark symptom of PTSD/ASD. Nightmares that cause significant distress or impair daily functioning should be addressed by a mental health professional. E. BP 122/80 mm Hg: This is a normal blood pressure reading for a 16-year-old and does not require follow-up. F. Smoking marijuana to clear their mind: Self-medicating with substances can indicate maladaptive coping mechanisms and increases the risk of substance use disorders. This requires follow-up to ensure the client receives healthier coping strategies. G. Startles easily during thunderstorms: The client states they have always been afraid of thunderstorms, making it unclear whether this is a new trauma-related symptom or a preexisting phobia. While increased startle response can be a PTSD symptom, it does not require immediate follow-up unless it significantly impairs functioning. H. Heart rate 99/min: While slightly elevated, this heart rate is within an acceptable range for a teenager, particularly one experiencing anxiety. It does not require urgent intervention.