A nurse is preparing to administer recommended immunizations to a 12-month-old infant who is up-to-date with the current schedule. Which of the following immunizations should the nurse plan to administer?Select all that apply.

A. Nephrotic syndrome typically presents with edema, proteinuria, hypoalbuminemia, and hyperlipidemia, rather than the symptoms described in the scenario.
B. Renal scarring can occur as a complication of untreated or recurrent urinary tract infections (UTIs), particularly pyelonephritis. The presence of fever and lethargy in the child, along with the history of decreased appetite, raises concerns for a urinary tract infection that could lead to renal scarring if left untreated.
C. Polycystic kidney disease typically presents later in life and is not typically associated with acute febrile illness in a 1-year-old toddler.
D. While acute glomerulonephritis can occur following certain infections such as streptococcal infections, it is less commonly associated with fever and lethargy compared to pyelonephritis.

E. Pyelonephritis is a bacterial infection of the kidneys commonly associated with fever and lethargy, especially in young children. The fever and lethargy reported by the parent, along with the urine sample obtained, suggest a concern for pyelonephritis.

Rationale:

A. Rolling over from back to abdomen typically occurs around 4 to 6 months of age.

While it may be slightly delayed, it is not usually concerning at 5 months.

B. Head lag at 5 months is abnormal and may indicate weakness or poor muscle tone, warranting further evaluation by the healthcare provider.

C. Not all infants are able to hold a bottle at 5 months, and this finding alone may not be concerning.

D. The grasp reflex typically diminishes by 3 to 4 months of age, so it may not be present at 5 months. While it's a developmental milestone, its absence alone may not warrant immediate concern at this age.