A nurse is caring for an adolescent in the emergency department (ED) Nurses' Notes 0700 Adolescent admitted to ED. Adolescent's parents are concerned about left leg injury that appears to be getting worse. Parents report adolescent has had fever, decreased appetite, and decreased energy within the past 2 days. Adolescent reports leg injury occurred while playing soccer. 0715 Adolescent is alert and oriented to person, place, time, and situation. Adolescent reports left lower leg pain as 4 on {Ans: Which of the following findings requires immediate follow up by the nurse? - Skin assessment - Temperature - WBC - Casual blood glucose - Potassium After reviewing the information in the adolescent's EMR and recognizing cues, the nurse should identify that the adolescent has a potential skin infection, such as cellulitis. The skin assessment reveals that the medial lateral aspect of the left leg has a 3 x 3 cm2 area of redness with small pustules, tenderness, and warmth, which can indicate infection. The adolescent's temperature and WBC count are above the expected reference range, which can also indicate infection. The adolescent's casual blood glucose and potassium are above the expected reference range, which can indicate infection or a complication