A nurse is reviewing the laboratory results of four children. Which value should the nurse report to the provider?

The correct answer is Choice A

Choice A rationale: Serum iron levels in children typically range from 50 to 120 mcg/dL. A value of 38 mcg/dL is significantly below the lower limit, indicating possible iron deficiency. Iron is essential for hemoglobin synthesis, oxygen transport, and cognitive development. Deficiency can lead to microcytic anemia, fatigue, and developmental delays. Early detection is critical, especially in pediatric populations where growth and neurodevelopment are rapid. This abnormal value warrants prompt provider notification for further evaluation and intervention.

Choice B rationale: Normal red blood cell (RBC) count in children ranges from approximately 4.1 to 5.5 million/mm³. A value of 4.9 million/mm³ falls comfortably within this range and does not suggest anemia or polycythemia. RBC count reflects bone marrow function and oxygen-carrying capacity. In the absence of symptoms or abnormal hemoglobin levels, this value is considered physiologically appropriate and does not require provider notification. It supports adequate erythropoiesis and oxygenation in the pediatric patient.

Choice C rationale: White blood cell (WBC) count in children typically ranges from 5,000 to 10,000 cells/mm³. A value of 10,000 cells/mm³ is at the upper limit of normal and may reflect mild physiological variation, such as recent activity or minor stress. It does not indicate infection, inflammation, or hematologic disorder unless accompanied by clinical symptoms or abnormal differential counts. Therefore, this value is not considered pathologic and does not require immediate reporting to the provider.

Choice D rationale: Blood lead levels below 5 mcg/dL are considered acceptable by CDC standards, although no level is truly safe. A value of 2 mcg/dL is within the expected range and does not indicate acute toxicity or environmental exposure requiring intervention. Lead affects neurological development, but levels under 5 mcg/dL are generally monitored without urgent action. Continued surveillance and environmental precautions are advised, but this value does not necessitate immediate provider notification.