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ecchymosis to the armsAssessment is essential to determine the cause for the infant's poor feeding because infants are at a high risk for dehydration. Infants do not begin to move or ambulate on their own prior to the age of 6 months, when they begin to crawl; therefore, any bruises on an infant before the age of 6 months is cause for suspicion. Based on this information, the finding that indicates a need to assess for child abuse is ecchymosis to the arms. Although a diaper rash could be indicative of neglect, this infant's rash is mild and is not a finding that supports the need to assess for child abuse. The sunken fontanelle and dry mucous membranes support a diagnosis of dehydration, which is why the pediatrician advised the parents to report to the ED.
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