A nurse in a provider's office is assessing the vital signs of a 2-year-old child at a well-child visit.
Which of the following findings should the nurse report to the provider?

D.

Choice A rationale:

Fever is a common sign of acute otitis media, indicating an infection. Elevated body temperature is a natural response to infection as the body tries to fight off the invading pathogens.

Choice B rationale:

Crying is a common symptom in infants with acute otitis media due to ear pain and discomfort caused by the infection. It is a way for the infant to express distress.

Choice C rationale:

Enlarged subclavicular lymph node is not a typical finding in acute otitis media. Enlarged lymph nodes can indicate an immune response but are not specific to this condition.

Choice D rationale:

Restlessness can be a symptom of acute otitis media. Infants may become irritable and have difficulty sleeping due to ear pain and discomfort.

Choice E rationale:

Increased appetite is not a typical finding in acute otitis media. Illnesses often cause a decreased appetite rather than an increased one.

Choice A rationale:

A blood pressure of 95/56 mm Hg is within the normal range for a 5-year-old child. While assessing vital signs, the nurse should consider the patient's age-specific parameters. In this case, the blood pressure is not indicative of hemorrhage.

Choice B rationale:

Flushing of the face might be a common postoperative finding and is not necessarily indicative of hemorrhage. It can be caused by various factors such as anesthesia or emotional states. Flushing alone is not a reliable sign of hemorrhage and should be assessed in conjunction with other symptoms.

Choice C rationale:

Continuous swallowing, especially with an increased heart rate and signs of restlessness, can be indicative of hemorrhage after a tonsillectomy and adenoidectomy. Frequent swallowing suggests the presence of blood in the mouth or throat, indicating possible bleeding at the surgical site. This finding requires immediate attention and intervention by the nurse.

Choice D rationale:

A heart rate of 54/min is below the normal range for a 5-year-old child, which typically ranges from 70 to 120 beats per minute. While bradycardia can be a concern, the more specific and immediate indication of hemorrhage in this case is continuous swallowing, which signals active bleeding from the surgical site.