A nurse is providing care to a child who has Down syndrome during a well-child checkup. Which of the following assessment findings requires immediate follow-up by the nurse?

A. Changes in feeding and bowel habits. In children with Down syndrome, sudden changes in feeding and bowel habits can indicate serious conditions such as gastrointestinal obstruction (e.g., Hirschsprung’s disease) or hypothyroidism. These conditions require immediate follow-up as they can lead to complications like malnutrition or bowel obstruction. B. Presence of a single palmar crease on the child's hands. A single transverse palmar crease (simian crease) is a common physical feature in Down syndrome but is not an urgent concern. It does not require immediate medical intervention. C. Height and weight measurement below the 50th percentile for their age. Children with Down syndrome often have shorter stature and lower weight percentiles due to their genetic condition. While growth monitoring is important, it is not an immediate concern unless severe failure to thrive is present. D. Evaluation of the caregiver's financial resources. Assessing financial resources is important for long-term care planning, but it does not require urgent medical intervention. Immediate follow-up should prioritize health concerns affecting the child’s well-being.