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 the administration of this medication?

Choice A: This statement is correct, as a fracture of an epiphyseal plate, which is a cartilage layer at the end of a long bone where growth occurs, can impair the normal growth and development of the bone. Depending on the type and severity of the fracture, the epiphyseal plate may close prematurely, stop growing, or grow unevenly, resulting in deformity, shortening, or angular deviation of the affected limb.

Choice B: This statement is incorrect, as a fracture of an epiphyseal plate does not necessarily disrupt the blood supply to the bone unless there is also damage to the periosteum, which is a membrane that covers and nourishes

the bone. A disruption of the blood supply to the bone can cause avascular necrosis, which is a condition that causes bone death due to lack of oxygen and nutrients.

Choice C: This statement is incorrect, as a fracture of an epiphyseal plate does not cause bone marrow loss through the fracture unless there is damage to the medullary cavity, which is a hollow space within the bone that contains bone marrow. Bone marrow loss through the fracture can cause bleeding, infection, or anemia.

Choice D: This statement is incorrect, as a fracture of an epiphyseal plate does not take longer to heal in younger children than in older children. In fact, younger children tend to heal faster than older children due to their higher metabolic rate, greater blood supply, and more active growth factors. The healing time of a fracture depends on various factors, such as the type and location of the fracture, the treatment method, and the presence of complications.

Choice A reason: This choice is incorrect because a 1-year-old toddler who has roseola and a temperature of 39° C (102.2° F) is not the most urgent case to assess. Roseola is a viral infection that causes a rash on the trunk and limbs, followed by a high fever that lasts for several days. It usually affects infants and young children and is self-limiting.
The fever can be managed by giving antipyretics such as acetaminophen or ibuprofen, and by providing fluids and comfort measures. The fever does not indicate any serious complication or threat to life.

Choice B reason: This choice is incorrect because a 4-year-old child who has asthma and an O2 sat of 97% is not the most urgent case to assess. Asthma is a chronic respiratory condition that causes inflammation and narrowing of the airways, leading to wheezing, coughing, chest tightness, or shortness of breath. It may be triggered by allergens, irritants, exercise, or infections. The O2 sat is a measure of oxygen saturation in the blood, which indicates how well oxygen is delivered to the tissues. A normal O2 sat range is 95% to 100%, so an O2 sat of 97% indicates that the child has adequate oxygenation and is not in respiratory distress.

Choice C reason: This choice is correct because a 10-year-old child who has sickle cell anemia and reports severe chest pain is the most urgent case to assess. Sickle cell anemia is a genetic disorder that causes the red blood cells to become sickle-shaped and clump together, blocking the blood flow and oxygen delivery to the organs and tissues. It may cause severe pain in the chest, abdomen, joints, or bones, as well as symptoms such as pallor, jaundice, fatigue, or shortness of breath. Severe chest pain may indicate acute chest syndrome, which is a life-threatening complication of sickle cell anemia that involves infection or infarction of the lungs. It may cause fever, cough, hypoxia, or respiratory failure. Therefore, assessing and treating this child is a priority to prevent further damage and death.

Choice D reason: This choice is incorrect because a 7-year-old child who has diabetes insipidus and a urine specific gravity of 1.016 is not the most urgent case to assess. Diabetes insipidus is a rare disorder that affects the balance of fluids in the body. It causes the kidneys to produce large amounts of dilute urine, leading to polyuria, polydipsia, dehydration, or electrolyte imbalance. It may be caused by a deficiency of antidiuretic hormone (ADH) or a resistance to its action. The urine specific gravity is a measure of urine concentration, which indicates how well the kidneys are functioning. A normal urine specific gravity range is 1.005 to 1.030, so a urine specific gravity of 1.016 indicates that the child has normal urine concentration and is not dehydrated.