A nurse is assessing an 18-month-old toddler during a well-child visit. Which of the following findings should the nurse identify as a potential developmental delay?

A. Vomiting is a common symptom of NEC. It can occur due to the inflammation and necrosis in the intestines, which disrupt normal digestion and absorption. In NEC, the vomit may also contain bile or even blood, depending on the severity of the condition.
B. Tachypnea, or rapid breathing, can be observed in infants with NEC, though it is not the most specific sign. Tachypnea may result from the body's response to systemic infection or sepsis, which can occur with NEC. However, tachypnea alone is not as directly indicative of NEC compared to other signs.
C. Hypertension (high blood pressure) is not a typical finding associated with NEC. The condition is more commonly linked with signs of gastrointestinal distress and systemic infection. Hypertension is less commonly observed in this context and is not a primary indicator of NEC.
D. A rounded abdomen can be a sign of abdominal distension, which is a key finding in NEC. Abdominal distension occurs due to the accumulation of gas and fluid in the intestines as a result of inflammation and necrosis. This can lead to a visibly swollen or rounded appearance of the abdomen.

A. This is within the normal range for a school-age child and does not require immediate reporting.
B. This is a significant amount of drainage and should be reported to the provider as it may indicate ongoing bleeding or fluid accumulation.
C. Serous drainage is expected in the early postoperative period and does not require immediate reporting.
D. Fluctuation in the water-sealed chamber is normal and indicates that the chest tube system is functioning correctly.