A nurse is providing teaching to the parent of a child who has a new prescription for methylphenidate. Which of the following instructions should the nurse include?

A. Iron deficiency anemia: Whole milk is a poor source of iron, and excessive consumption of whole milk can displace iron-rich foods from the diet. Therefore, a toddler who consumes a large amount of whole milk and has a poor appetite is at risk for iron deficiency anemia due to inadequate iron intake. Iron deficiency anemia is characterized by low levels of iron in the body, leading to decreased production of red blood cells and impaired oxygen transport.

B. Vitamin A toxicity: While excessive intake of vitamin A can lead to toxicity, it is unlikely to occur from consuming whole milk alone. Vitamin A toxicity is more commonly associated with excessive intake of vitamin A supplements or foods that are rich in preformed vitamin A, such as liver. Therefore, vitamin A toxicity is not a significant risk for a toddler who drinks whole milk.

C. Impaired carbohydrate metabolism: There is no direct relationship between whole milk consumption and impaired carbohydrate metabolism. Impaired carbohydrate metabolism is typically associated with conditions such as diabetes mellitus or metabolic syndrome, rather than dietary factors like milk consumption.

D. Lactose intolerance: Lactose intolerance is the inability to digest lactose, the sugar found in milk and dairy products, due to a deficiency of the enzyme lactase. While excessive consumption of whole milk may exacerbate symptoms in a child with lactose intolerance, it is not a risk factor for developing lactose intolerance itself. Lactose intolerance is more commonly observed in individuals of certain ethnic backgrounds or those with a genetic predisposition.

A. Initiate an infusion of IV fluids:

Administering IV fluids may be necessary to maintain hydration and support circulation, but it is not the first action to take in managing status asthmaticus. In this acute situation, the priority is to address airway obstruction and respiratory distress.

B. Obtain a blood specimen for ABG analysis:

Obtaining arterial blood gas (ABG) analysis can provide valuable information about the child's respiratory status, including oxygenation and acid-base balance. However, it is not the first action to take in managing status asthmaticus.

C. Administer a dose of an IV corticosteroid:

Administering systemic corticosteroids (such as IV hydrocortisone or methylprednisolone) is a crucial intervention in managing status asthmaticus to reduce airway inflammation and improve respiratory function. However, it is not the first action to take.

D. Apply humidified oxygen:

This is the correct action to take first. Applying humidified oxygen helps improve oxygenation and relieve bronchospasm by providing supplemental oxygen to the child's lungs. Oxygen therapy is essential in managing respiratory distress associated with status asthmaticus and should be initiated promptly.