A nurse is assisting in the care of an adolescent.

The nurse is reviewing the data collection findings.

Select the 5 findings the nurse should report to the provider.

A. A toddler who has periorbital cellulitis and has an axillary temperature of 37.6°C (99.7°F): A mild temperature in the context of periorbital cellulitis is expected and not an immediate emergency. Although periorbital cellulitis can be serious, this temperature alone does not demand immediate action over other critical symptoms.

B. An adolescent who has influenza and reports a headache of 6 on a scale of 0 to 10: A headache with influenza is common and requires monitoring, but unless there are signs of severe neurological involvement, it is not the highest priority compared to potential circulatory compromise.

C. An infant who had a pyloromyotomy 12 hr ago and spit up after the last feeding: Mild vomiting or spitting up is common following a pyloromyotomy and is not unusual within the first 24 hours postoperatively. It generally does not require immediate intervention unless persistent or worsening.

D. A child who had a cast placed 4 hr ago and reports numbness in the affected extremity: Numbness may indicate impaired circulation or nerve compression, a sign of possible compartment syndrome. This is a surgical emergency that can result in permanent damage if not promptly assessed and treated.

A. Attach a blood pressure cuff to the client's upper arm: A blood pressure cuff is not involved in obtaining a 12-lead ECG. Although blood pressure may be assessed separately, it is not part of the ECG procedure itself and would not aid in capturing accurate cardiac electrical activity.

B. Assist the client to the orthopneic position: The orthopneic position, which involves leaning forward, is used to ease breathing difficulties, not for ECG recording. For an ECG, the client should be lying flat or in a semi-reclined supine position to ensure consistent and accurate electrode placement.

C. Tell the client to expect a mild stinging sensation during the test: A 12-lead ECG is a painless, non-invasive procedure. Electrodes are applied to the skin's surface to measure electrical activity; there should be no pain or stinging involved unless the skin is abraded during preparation.

D. Instruct the client to remain as still as possible during the recording: Movement can cause artifacts on the ECG tracing, making it difficult to interpret accurately. Instructing the client to stay still helps ensure a clean recording and minimizes interference from muscle tremors or motion.