A nurse is flushing a client's intermittent infusion device. The client states, "Why do you have to do that if you are not giving me medicine?" Which of the following statements should the nurse make?

Rationale:

A. Pale and a 24-hr fluid deficit of 30 mL: Mild pallor and a small fluid deficit are not uncommon in early stages of illness and may not require immediate intervention. However, more serious signs of dehydration would take priority for reporting.

B. Temperature 38° C (100.4° F) and pulse rate 124/min: These are within expected limits for an infant with mild infection or fever. While they should be monitored, they are not urgent indicators of severe complications from gastroenteritis.

C. Decreased appetite and irritability: These are common symptoms in infants with viral illnesses, including gastroenteritis. Although they affect comfort and feeding, they are not necessarily indicators of serious fluid or electrolyte imbalance.

D. Sunken fontanels and dry mucous membranes: These are clinical signs of moderate to severe dehydration, which is a serious complication of gastroenteritis in infants. These findings must be reported promptly for urgent intervention to prevent further deterioration.

Rationale:

A. Providing the client with information about transportation services: This helps address access barriers but focuses on support services rather than directly organizing or integrating healthcare delivery, which is central to coordination of care.

B. Informing the client about providers who accept their health insurance: While helpful, this action centers on financial guidance. It supports access but does not actively bridge or organize care among multiple services or settings.

C. Arranging an appointment for the client with a mobile health clinic: Coordinating an appointment directly connects the client with needed services, especially in underserved rural areas. This reflects active care coordination by ensuring timely access to care and reducing system fragmentation.

D. Encouraging the client to become a self-advocate: Promoting self-advocacy empowers the client in their health journey but does not represent coordination of care. Coordination involves organizing and facilitating access across providers and settings.