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. During a 24-hour urine collection, all urine produced over the 24-hour period should be collected in a single container. The final specimen (the last urine voided at the end of the 24 hours) should be added to the same container as the rest of the collected urine, not saved separately.
B. For a 24-hour urine collection, there is no need to cleanse the perineum with a povidone-iodine solution before each collection. The focus should be on collecting all urine over the 24-hour period in the designated container. However, proper hygiene practices are important to avoid contamination.
C. The 24-hour urine collection starts after the first void of the day, which should be discarded. The collection begins with the second void and continues until the same time the next day, including the final void. Discarding the first void is essential to ensure that the collection accurately reflects the urine produced over a full 24-hour period.
D. During a 24-hour urine collection, the client should void as needed but collect all urine produced over the 24 hours in the designated container. There is no requirement to void every hour; the key is to ensure that every drop of urine is collected and included in the total 24-hour collection period.

A. Shakiness is a common symptom of hypoglycemia. When blood glucose levels drop, the body may react with symptoms like trembling or shaking. This is because low blood sugar levels can trigger the release of adrenaline, leading to physical symptoms such as shakiness.
B. While decreased appetite can occur in various conditions, it is not a primary or specific manifestation of hypoglycemia. Typically, hypoglycemia causes symptoms related to the body’s response to low glucose levels, such as shakiness, sweating, or confusion, rather than a decrease in appetite.
C. Thirst is more commonly associated with hyperglycemia (high blood glucose levels), not hypoglycemia. When blood glucose levels are high, the body tries to get rid of the excess sugar through increased urination, leading to dehydration and increased thirst. This is not a typical sign of low blood sugar.
D. Increased capillary refill time is generally a sign of poor perfusion or dehydration and is not specific to hypoglycemia. In hypoglycemia, the capillary refill time is usually normal, though other signs such as shakiness, sweating, or irritability are more indicative of low blood sugar levels.