A nurse in a pediatric clinic is caring for a child who has iron deficiency anemia and a new prescription for ferrous sulfate tablets. Which of the following instructions should the nurse provide the parents regarding administration of this medication?

A. Areola and papilla separate from the contour of the breast: This is a normal finding in breast development and indicates Tanner stage 4 or higher, which is typical for adolescent girls. It does not necessarily indicate a developmental delay.

B. Absence of first menstrual perioD. Menarche, the first menstrual period, typically occurs between the ages of 9 and 15 in girls. Absence of menarche by the age of 15 or within 3 years after the onset of breast development (thelarche) may indicate a developmental delay or underlying medical condition that should be evaluated by a healthcare provider.

C. Developed breast tissuE. Breast development, indicated by palpable breast tissue, is a normal part of female puberty and typically occurs before menarche. Developed breast tissue alone does not necessarily indicate a developmental delay.

D. Mature distribution and coarseness of pubic hair: Pubic hair development is also a part of female puberty and occurs before or around the time of menarche. While the distribution and coarseness of pubic hair can provide information about pubertal development, the absence of menarche is a more reliable indicator of a potential developmental delay.

A. Administer at mealtimes: While iron supplements can be given with meals to reduce gastrointestinal upset, they are typically better absorbed on an empty stomach. Therefore, giving them at mealtimes may not optimize absorption.

B. Administer at bedtimE. Administering iron supplements at bedtime is not typically recommended unless specifically instructed by a healthcare provider.

C. Give with a 240 mL (8 oz) glass of milk: Milk can decrease the absorption of iron due to its calcium content, so giving iron supplements with milk is not recommended.

D. Give with orange juicE. Vitamin C enhances iron absorption, so giving iron supplements with orange juice is a common practice to improve absorption.