A school nurse is assessing a child and notes various bruises on the child's body that are unexplained. Which of the following actions should the school nurse take?

Rationale:

A. Boiled eggs: While eggs contain some iron, the type is nonheme, and their consumption alone does not significantly enhance absorption. Eggs lack the vitamin C necessary to improve nonheme iron absorption from plant-based foods.

B. Cheddar cheese: Cheese contains minimal iron and is low in vitamin C. It does not aid in the absorption of nonheme iron and may actually inhibit iron absorption when consumed with iron-rich plant foods due to its high calcium content.

C. Mixed nuts: Nuts provide some nonheme iron, but they do not contain vitamin C to enhance absorption. Consuming nuts alone will not improve bioavailability of iron in a vegetarian diet.

D. Orange slices: Vitamin C in oranges significantly enhances the absorption of nonheme iron from plant-based foods by converting it into a more absorbable form. Including vitamin C-rich foods like oranges with meals helps increase iron uptake, which is particularly important for clients following vegetarian diets.

Rationale:

A. Increased hemoglobin: A rise in hemoglobin is not expected after surgery but also does not suggest a postoperative complication. It may reflect hemoconcentration from mild dehydration or fluid shifts. This finding does not indicate infection, thrombosis, or impaired healing, so it is not a priority concern at this stage.

B. Increased urinary output: Higher urinary output may occur if the client is well-hydrated or receiving IV fluids. This finding does not suggest renal impairment or postoperative complications. As long as urine is clear and the client is stable, increased output is not concerning and requires only routine monitoring.

C. Unilateral leg swelling: One-sided leg swelling is a hallmark sign of deep vein thrombosis, a serious complication after pelvic surgery due to venous stasis and immobilization. A DVT can progress to pulmonary embolism, posing immediate danger. The finding requires prompt evaluation and intervention to prevent life-threatening complications.

D. Mild pain at the surgical site: Mild incisional pain is expected on postoperative day three as tissues heal and inflammation decreases. This finding is typical and manageable with analgesics. As long as pain is not severe or accompanied by fever, redness, or purulent drainage, it does not indicate a complication.