A nurse at a pediatrician’s office answers a phone call from a parent whose child just ingested 15 vitamin tablets with added ferrous sulfate. Which of the following instructions should the nurse give to the parent?

Choice A reason: Syrup of ipecac induces vomiting but is no longer recommended for iron overdose, as it may delay definitive treatment. Ferrous sulfate ingestion causes gastrointestinal toxicity, metabolic acidosis, and organ damage. Poison control provides specific guidance, making ipecac inappropriate, as it risks aspiration and delays chelation therapy. Choice B reason: Orange juice contains vitamin C, which enhances iron absorption, potentially worsening toxicity in ferrous sulfate overdose. Iron causes mucosal damage, acidosis, and systemic toxicity. Giving juice is harmful, as it does not neutralize iron or address toxicity, making poison control contact the priority for expert management. Choice C reason: A high carbohydrate snack does not address iron toxicity from ferrous sulfate ingestion, which causes gastrointestinal irritation, metabolic acidosis, and organ damage. Carbohydrates may delay treatment by occupying the stomach. Poison control offers specific interventions like chelation, making this an ineffective and inappropriate response to the overdose. Choice D reason: Contacting poison control is critical for ferrous sulfate overdose, as iron causes severe toxicity, including gastrointestinal bleeding, metabolic acidosis, and liver damage. Poison control provides immediate guidance on decontamination, chelation therapy (e.g., deferoxamine), and monitoring, ensuring rapid intervention to prevent life-threatening complications in the child.