The emergency department nurse is assessing a 14-month-old child who was left inside a closed car for an hour. The outside temperature was 88 degrees Fahrenheit. Which assessment findings will the nurse report immediately to the health care provider? Select all that apply.

Choice A reason: While a child with asthma exacerbation needs monitoring, they used their rescue inhaler 16 hours ago and are currently stable. This patient is not the highest priority.

Choice B reason: A 3-year-old who continues to cough with an oxygen saturation of 91% is at risk of respiratory distress or obstruction due to the swallowed sunflower seeds. The low oxygen saturation indicates impaired gas exchange and requires immediate attention.

Choice C reason: A 15-year-old recovering from a laparoscopic appendectomy who is stable and preparing for discharge can wait to be seen after more urgent cases.

Choice D reason: An 18-month-old admitted for dehydration who is producing a normal number of wet diapers and eating well indicates improved hydration status and can be seen after addressing the more critical situation.

Choice A reason: Feeding the baby while lying in the bassinet can pose a significant risk of choking and improper feeding technique. Babies should be fed while being held in an upright or semi-upright position to ensure proper swallowing and to prevent aspiration of milk into their airways. This practice promotes bonding between the caregiver and the baby and supports the baby’s overall feeding development. Therefore, further teaching is required for parents who feed their baby while the baby is lying in the bassinet.

Choice B reason: Periodically pausing the feeding is actually a recommended practice as it allows the baby to burp and prevents overfeeding. It also gives the baby a break to catch their breath and reset their sucking pattern. This technique can reduce the risk of discomfort and gas. Hence, this behaviour does not require further teaching.

Choice C reason: Discarding the remaining milk after one hour is a proper practice because milk can spoil and become contaminated with bacteria, leading to potential health risks for the baby if consumed. It is important to ensure that the baby is fed with fresh milk to avoid any health issues. Therefore, this behaviour does not require further teaching.

Choice D reason: Holding the baby upright during feedings is a correct and recommended practice. This position helps to prevent ear infections, reduces the risk of choking, and promotes better digestion. It ensures that the milk flows steadily and safely into the baby's mouth, aiding in a more efficient feeding process. Thus, this behaviour does not require further teaching.