A client with fair skin, who is an avid runner, is diagnosed with malignant melanoma, located on the lateral surface of the lower leg. After a wide margin resection, the nurse provides discharge teaching. It is most important for the nurse to emphasize the need to observe for changes in which characteristic?

A. Increase in monocytes and macrophages. Monocytes and macrophages are key immune cells involved in the inflammatory response. Monocytes migrate to the affected tissue, where they differentiate into macrophages and help clear pathogens, dead cells, and debris. Their presence indicates an ongoing or chronic inflammatory process.
B. Predominance of megakaryocytes. Megakaryocytes are large bone marrow cells responsible for platelet production. They are not involved in inflammation and are typically found in the bone marrow, not in inflamed tissues.
C. Presence of fibroblasts and collagen. Fibroblasts and collagen are associated with tissue repair and scar formation rather than active inflammation. Their presence suggests healing and fibrosis rather than an acute inflammatory response.
D. Prevalence of dead neutrophils. Dead neutrophils are a hallmark of pus formation (suppuration) in bacterial infections but do not necessarily indicate ongoing inflammation. Neutrophils are the first responders in acute inflammation, but their presence alone does not define an inflammatory process—the presence of active immune cells like macrophages is more indicative.

A. Explain that the child is likely to grow into her weight. This is incorrect because a BMI at the 85th percentile indicates that the child is overweight. Without intervention, the risk of continued excess weight gain and future obesity increases.
B. Obtain the child's 3-day diet history based on the mother's input. Assessing the child's dietary habits helps identify potential areas for improvement, such as reducing sugary drinks or increasing fruit and vegetable intake. Understanding the child’s nutrition is essential for developing a healthy eating plan.
C. Tell the mother that girls hit their growth spurt before boys so eating more is expected. While girls do experience growth spurts earlier than boys, this does not justify excessive weight gain. Encouraging healthy eating and physical activity is more appropriate than assuming the child will "grow out of it."
D. Inquire as to whether or not the school has a physical education program. School-based physical activity plays an important role in weight management. If the school lacks a structured program, additional strategies for physical activity should be explored.
E. Determine the child's usual physical activity pattern. Assessing the child’s activity level helps identify if sedentary behaviors (e.g., excessive screen time) are contributing to weight gain. Encouraging regular physical activity is a key part of managing childhood obesity.