The busy emergency department at a hospital has experienced a sharp increase in negative outcomes among clients with heart conditions in the past month. Which of the following actions should the nursing staff take to improve client outcomes?

A. Ulcerative colitis can lead to iron deficiency anemia due to chronic inflammation, intestinal bleeding, and malabsorption of nutrients. The disease often affects the colon, which can result in blood loss and inadequate iron absorption.
B. A diet high in prepackaged and processed foods is often low in essential nutrients, including iron. These foods may lack whole grains, fruits, vegetables, and other sources of dietary iron, increasing the risk of iron deficiency anemia.
C. Treatment for gastrointestinal cancer, such as surgery or chemotherapy, can lead to changes in absorption and increased risk of bleeding. This history can significantly elevate the risk for developing iron deficiency anemia due to potential blood loss and malabsorption issues.
D. Gastric bypass surgery can lead to iron deficiency anemia due to reduced stomach size and changes in the gastrointestinal tract that impair nutrient absorption. Patients often need to supplement their diet with iron and other vitamins after surgery.
E. Eating red meat daily is generally associated with an adequate intake of heme iron, which is more easily absorbed by the body compared to non-heme iron found in plant sources. While it's important to consider overall dietary patterns, this particular factor does not typically pose a risk for iron deficiency anemia.

A. While it is important to address concerns about impairment, confronting the nurse directly can be counterproductive and may escalate the situation. It is essential to approach the situation with caution and follow established protocols for dealing with suspected substance impairment.
B. While gathering observations from colleagues may seem reasonable, it can create a culture of gossip and may violate confidentiality. This approach can also lead to misinformation and should not be the first step in addressing a serious concern about a colleague's safety and well-being.
C. Documenting observations is important, but it should not be the sole action taken at this point. Communicating with the personnel department is part of the process if the situation escalates, but immediate action is necessary to ensure patient safety.
D. This option is the most appropriate initial action. By closely monitoring the nurse’s behavior, the manager can gather more information before taking further steps. This approach allows for the collection of objective data and ensures patient safety while avoiding premature accusations.