A nurse is caring for a toddler admitted to the hospital. Exhibits Click to highlight the findings that require immediate follow-up. To deselect a finding, click on the finding again. Body system Findings Respiratory Respiratory rate 26/min Cardiovascular Heart rate 112/min Capillary refill 4 seconds Gastrointestinal Hyperactive bowel sounds Integumentary Diaper area reddened Extremities cool Reports no tears Neurologic Lethargic

A. Capillary refill of 4 seconds is prolonged and indicates poor perfusion, which is a sign of worsening dehydration or possible shock. This requires immediate follow-up. B. Hyperactive bowel sounds are expected in a toddler with diarrhea and do not indicate immediate deterioration. C. Cool extremities suggest poor circulation and possible hypovolemia or shock, requiring urgent assessment. D. Absence of tears is a classic sign of dehydration in a toddler and indicates worsening fluid deficit that needs prompt intervention. E. Diaper area redness is common with diarrhea and indicates skin irritation, but it is not a priority compared to signs of dehydration or shock. F. Lethargy is a concerning neurologic change and may indicate severe dehydration or decreased perfusion, requiring immediate attention. G. Heart rate of 112/min is within expected range for a toddler and does not indicate acute deterioration. H. Respiratory rate of 26/min is within normal limits for a toddler and is not a priority concern.