In the case of an infant with a suspected shunt malfunction, what assessment finding would warrant immediate attention?

In the context of an infant with a suspected shunt malfunction, the finding of a bulging fontanel warrants immediate attention due to its potential indication of increased intracranial pressure. A bulging fontanel can suggest that there is an accumulation of cerebrospinal fluid (CSF) which may be caused by a malfunctioning shunt. This situation can lead to serious complications, including brain injury or even life-threatening conditions if not addressed promptly.

While persistent irritability, crying upon handling, and increased tolerance to feeds may also be concerning and could indicate discomfort or other issues, they do not have the same immediate implications for neurological status that a bulging fontanel does. Thus, the presence of a bulging fontanel is particularly critical and should prompt swift evaluation and intervention to ensure the infant's safety and well-being.