A nurse is reinforcing teaching about bottle feeding techniques with the guardian of a newborn. Which of the following statements by the guardian indicates an understanding of the teaching?

A. Celiac disease: Celiac disease is an autoimmune disorder triggered by gluten ingestion that damages the small intestine and impairs nutrient absorption. While it can cause poor appetite and growth issues, high milk intake alone does not cause or increase the risk for celiac disease. Diagnosis is based on genetic susceptibility and gluten exposure, not dietary patterns.

B. Lactose intolerance: Lactose intolerance results from deficiency of lactase, leading to diarrhea, bloating, and abdominal discomfort after dairy consumption. Drinking large amounts of milk may exacerbate symptoms if the child is lactose intolerant, but intolerance is not caused solely by high milk intake.

C. Acute renal failure: Acute renal failure is typically caused by severe dehydration, infection, toxins, or obstruction and is not related to high milk intake in a toddler. Daily consumption of milk, even in large quantities, does not precipitate acute renal failure in a healthy child.

D. Iron-deficiency anemia: Excessive milk intake can displace iron-rich foods from the toddler’s diet and interfere with iron absorption, increasing the risk for iron-deficiency anemia. Milk is low in iron, and consuming more than 24 ounces per day can contribute to inadequate dietary iron intake and subsequent anemia in toddlers.

A. Discoloration at the postoperative site: Mild bruising or ecchymosis around the incision is common after arthroscopy and generally expected. It does not usually indicate a complication requiring immediate reporting.

B. Urinary output 150 mL/hr: A urinary output of 150 mL/hr is above the minimum expected hourly output (typically 30 mL/hr) and suggests adequate renal perfusion. This finding does not require immediate notification.

C. Client report of pain at the incision site: Some pain at the incision site is expected postoperatively. While pain should be managed, reporting to the provider is not urgent unless it is uncontrolled or accompanied by other concerning signs.

D. Blood pressure 78/38 mm Hg: Hypotension at this level is significant and can indicate hypovolemia, bleeding, or shock. Immediate reporting to the provider is necessary to prevent organ hypoperfusion and initiate prompt interventions.