A nurse is caring for a client who reports insomnia. The nurse should monitor the client for which of the following adverse effects of sleep deprivation? (Select all that apply.)

A. Hypothermia: Diarrhea usually causes fluid and electrolyte loss but does not directly result in hypothermia. More commonly, dehydration and electrolyte imbalances occur, while temperature changes are related to infection or other systemic causes.

B. Rigid abdomen: A rigid abdomen is often associated with peritonitis or acute abdominal emergencies, not uncomplicated diarrhea. Diarrhea generally causes cramping, urgency, and loose stools without producing abdominal rigidity.

C. Decreased bowel sounds: Diarrhea is caused by increased intestinal motility, so bowel sounds are typically hyperactive rather than decreased. Hypoactive or absent bowel sounds are seen more often with conditions like ileus or severe hypokalemia.

D. Dehydration: Persistent diarrhea leads to significant fluid and electrolyte loss, resulting in dehydration. Expected findings include dry mucous membranes, poor skin turgor, hypotension, and concentrated urine output.

A. Administer at mealtimes: Giving iron with meals decreases gastrointestinal irritation but also reduces absorption significantly. Optimal administration is on an empty stomach or with vitamin C–rich fluids to enhance absorption.

B. Administer at bedtime: Timing at bedtime does not enhance iron absorption or reduce adverse effects. Bedtime administration may even worsen gastrointestinal discomfort while the child is lying down.

C. Give with orange juice: Vitamin C in orange juice enhances the absorption of iron in the gastrointestinal tract. This improves the effectiveness of ferrous sulfate therapy in treating iron deficiency anemia.

D. Give with a 240 mL (8 oz) glass of milk: Milk contains calcium, which interferes with iron absorption. Administering ferrous sulfate with milk would reduce its therapeutic benefit and should be avoided.