A nurse in a well-child clinic is collecting data from four clients. Which of the following findings should the nurse report to the provider as a potential indication of child maltreatment?

Choice A rationale:
Avoiding discussions about the child's diagnosis with the sibling might create confusion and anxiety for the sibling. Open communication is essential for helping siblings understand their brother or sister's condition and cope with the changes in the family dynamic.
Choice B rationale:
Encouraging phone calls between the siblings is a positive step in promoting sibling adaptation when one of them has a chronic illness like cystic fibrosis. Maintaining connections through communication helps siblings feel involved, valued, and informed about each other's lives and challenges.
Choice C rationale:
Designating one parent to stay at home with the sibling might lead to feelings of isolation and neglect for the child with cystic fibrosis. Siblings also need support and attention during this time, and isolating one parent could hinder healthy sibling relationships.
Choice D rationale:
Avoiding having the sibling visit the child in the facility may prevent the sibling from understanding the condition and create a sense of fear or confusion. Controlled, supervised visits can actually be beneficial, as they allow the siblings to interact and support each other in a safe environment.

Choice A rationale:
Iron 100 mcg/dL The normal range for serum iron levels can vary based on age and gender, but typically, a range of 50 to 150 mcg/dL is considered normal. The provided value of 100 mcg/dL falls within this range and is not a cause for concern. Elevated iron levels can be indicative of hemochromatosis or other disorders, but this value is not concerning.
Choice B rationale:
Hemoglobin 8 g/dL Hemoglobin levels can vary by age and gender, but in general, a hemoglobin level of 8 g/dL is low and suggestive of anemia, a condition characterized by a reduced ability of the blood to carry oxygen. Anemia can lead to fatigue, weakness, and other symptoms, and the nurse should report this finding to the healthcare provider for further evaluation and management.
Choice C rationale:
Sodium 140 mEq/L The normal range for serum sodium levels is typically around 135 to 145 mEq/L. The provided value of 140 mEq/L falls within this normal range and is not a cause for concern. Deviations from this range can indicate various conditions, including dehydration or overhydration, but this value is within an acceptable range.
Choice D rationale:
Calcium 9 mg/dL The normal range for serum calcium levels can vary, but generally, a range of 8.5 to 10.5 mg/dL is considered normal. The provided value of 9 mg/dL falls within this range and is not significantly abnormal. Abnormal calcium levels can be indicative of various conditions, including thyroid disorders or kidney problems, but this value is not concerning.