A nurse in a pediatric clinic is talking with a parent of a toddler. The parent tells the nurse that her toddler drinks a quart of milk a day. The nurse should recognize that the toddler is at risk for which of the following disorders?

A. Active psychiatric disorder: The presence of an active psychiatric disorder, such as depression or anxiety, is the most significant risk factor for suicide. Mental health disorders can severely affect an adolescent's emotional and psychological well-being, increasing the risk of suicidal thoughts and behaviors.

B. Availability of firearms: While access to firearms increases the risk of successful suicide, it is a secondary risk factor compared to the presence of a psychiatric disorder, which is more directly linked to the development of suicidal ideation.

C. Family conflict: Family conflict is a risk factor for emotional distress and can contribute to suicidal thoughts, but it is less significant than having an active psychiatric disorder, which directly impacts the adolescent's mental health.

D. Homosexuality: While LGBTQ+ youth are at higher risk for suicide due to factors like discrimination and lack of support, the presence of an active psychiatric disorder remains a more critical and direct risk factor for suicide.

A. The parent reports the child will not keep the arm elevated on the pillow: Not a priority. While elevation is important, it is not immediately concerning.

B. The fingers on the right hand have a capillary refill of 4 seconds: Correct. A capillary refill time of more than 2 seconds indicates poor perfusion, which can be a sign of compartment syndrome, a serious complication.

C. The fingertips of the right hand are swollen and bruised: Concerning, but swelling and bruising can be normal post-injury. Immediate concern is perfusion.

D. The child is not attempting to move her right arm or fingers: Concerning, but can be due to pain or fear. Poor perfusion (B) is a more immediate threat.