Which of the following is NOT a symptom of gastrointestinal distress to assess?

In assessing symptoms of gastrointestinal distress, the focus is on physical manifestations that are directly related to the digestive system's function and associated issues. Vomiting is a clear sign of gastrointestinal distress and indicates possible conditions like infections, blockages, or food intolerances. Hydration status is crucial to evaluate because gastrointestinal issues often lead to fluid loss, particularly in cases of vomiting or diarrhea, necessitating close observation of the child's hydration levels.

Changes in appetite frequently accompany gastrointestinal distress as a child may refuse to eat or show decreased interest in food due to nausea, pain, or discomfort. This symptom is significant as it can indicate prevailing abdominal issues or systemic illness.

Ear pulling, while it may suggest an ear infection or discomfort in infants or young children, does not directly relate to gastrointestinal problems. Thus, it is not typically assessed within the context of gastrointestinal distress, making it the correct response for this question. Understanding the context of each symptom's relevance to gastrointestinal distress helps in determining the appropriate assessment focus.