[Solved]: The nurse is completing the admission assessment

The nurse is completing the admission assessment. Infant is sleeping but is easily aroused. When awake infant is restless and crying. Scalp is diaphoretic. Tachypneic with moderate nasal flaring and moderate intercostal, subcostal, and substernal retractions. Extremities are warm to touch, and capillary refill is 2 seconds. Peripheral pulses are a +2, central pulses are +3. Heart rate is 200/min when crying and at rest heart rate is 176/min. Loud Grade III murmur is heard upon auscultation. When crying, lips and mucous membranes are slightly cyanotic. Anterior fontanel is flat and soft. Breath sounds are clear and equal. Vital signs are temperature 36.9deg C (98.4deg F), heart rate 178/min, respirations 60/min, blood pressure 74/42 mm Hg, oxygen saturation: 88%. Infant is placed on a cardiorespiratory monitor and pulse oximeter. Admission weight 4000 g (8 lb 13 oz) Which of the following concerns should the nurse address while providing care? (Select all that apply.) Physiological: Gas Exchange Physiological: Intracranial regulation Physiological: Perfusion Physiological: Fluid and Electrolyte Physiological: Nutrition Physiological: Infection Physiological: Tissue Integrity