The school nurse is preparing a presentation for elementary school teachers to inform them about when a child should be referred to the school clinic for further follow-up. The teachers should be instructed to report what situation(s) to the school nurse? Select all that apply.

A. Shaking that changes the child's handwriting legibility could indicate a neurological or motor issue and warrants further assessment by the school nurse. B. Bruises on both knees after the weekend are likely minor and do not typically require immediate referral to the school nurse unless there are other concerning signs of abuse or injury. C. Sunburn with blisters on the face, arms, and hands could indicate severe sunburn and potential complications such as infection or dehydration, requiring evaluation by the school nurse. D. Refusing to complete written homework assignments may indicate behavioral issues or difficulties with learning but does not necessarily require immediate referral to the school nurse. E. Thirst and frequent requests for bathroom breaks could indicate underlying medical issues such as diabetes or urinary tract infection and should be reported to the school nurse for further assessment.