A nurse is reviewing the medical records of a group of clients. Which of the following findings should the nurse report to local authorities?

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.

Choice A rationale:
Pain following range-of-motion exercises is a significant finding that should be reported to the provider. It could indicate the possibility of complications, such as further injury or impaired healing. Adolescents with fractured bones are often encouraged to perform range-of-motion exercises to prevent stiffness and promote circulation. However, increased pain during or after these exercises could indicate problems like muscle strain or improper alignment of the fracture, which need to be addressed promptly.
Choice B rationale:
Pruritus (itching) under the cast is common and can be expected due to the accumulation of dead skin cells and sweat. While it can be uncomfortable for the client, it's not an urgent concern that requires immediate reporting to the provider. Strategies to alleviate itching, such as using a cool blow dryer under the cast, can be taught to the client.
Choice C rationale:
The presence of swelling while the extremity is dependent is a normal response to gravity and is not an alarming finding. Swelling when the extremity is dependent is expected, especially within the initial stages of fracture healing. It suggests that the blood supply is reaching the area for healing purposes. Elevation and rest can help reduce the swelling.
Choice D rationale:
Coolness of the toes could be due to reduced blood flow, but this finding alone may not be an immediate concern. It's essential to consider the client's overall circulation, capillary refill, and presence of pulses. If other signs of impaired circulation, such as pallor or delayed capillary refill, are present along with coolness, it might indicate compromised vascular supply. However, based on the information provided, this choice is not as urgent as reporting pain following range-of-motion exercises.