A nurse is providing teaching about iron deficiency anemia to the parents of a toddler. Which of the following should the nurse include as a method of preventing iron deficiency anemia?

Choice A reason: Acidic odors are not a sign of a perforated appendix, but rather a possible indication of gastroesophageal reflux disease (GERD), which is a condition that causes stomach acid to flow back into the esophagus¹.

Choice B reason: Sudden decrease in abdominal pain is a sign of a perforated appendix, which is a serious complication of acute appendicitis. When the appendix ruptures, the pressure inside the abdomen is released, causing a temporary relief of pain. However, this is followed by severe inflammation and infection of the peritoneum, which is the membrane that lines the abdominal cavity². This can lead to sepsis, shock, and death if not treated promptly.

Choice C reason: Narrow fever is not a term that is commonly used in medicine. Fever is a general sign of infection or inflammation, and it can be present in both acute appendicitis and perforated appendix. However, fever alone is not a reliable indicator of the severity or location of the problem³.

Choice D reason: Rigid abdomen is a sign of peritonitis, which is a possible consequence of a perforated appendix. Peritonitis causes the abdominal muscles to contract and become stiff, making the abdomen hard and tender to touch². However, rigidity can also occur in other conditions that cause intra-abdominal inflammation, such as pancreatitis or cholecystitis⁴.

Choice E reason: Nausea is a common symptom of acute appendicitis, but it is not specific to a perforated appendix. Nausea can be caused by irritation of the stomach or the nerves that control vomiting. It can also occur in other gastrointestinal disorders, such as gastritis or gastroenteritis⁵.

Choice A reason: A soft diet is appropriate for a toddler who has a cleft palate repair, as it prevents trauma to the surgical site and promotes healing. The nurse should avoid foods that are hard, sticky, or spicy.

Choice B reason: Offering fluids through a straw is not an appropriate action, as it can create negative pressure in the mouth and disrupt the suture line. The nurse should offer fluids with a cup or a spoon.

Choice C reason: Administering opioids for pain is not an appropriate action, as opioids can cause respiratory depression and sedation in toddlers. The nurse should use non-opioid analgesics such as acetaminophen or ibuprofen, unless otherwise prescribed.

Choice D reason: Applying bilateral wrist restraints is not an appropriate action, as it can cause injury and distress to the toddler. The nurse should use other methods to prevent the toddler from touching the surgical site, such as distraction, toys, or mittens.