For an 18-month-old toddler with a blood lead level of 3 mcg/dL, what should the nurse's follow-up recommendation be?

For an 18-month-old toddler with a blood lead level of 3 mcg/dL, the appropriate follow-up recommendation is to rescreen in 1 year. This level is considered low and does not typically require immediate intervention. In children, a blood lead level below 5 mcg/dL is often monitored rather than treated. The standard practice involves re-evaluating lead levels at regular intervals to ensure that any potential exposure is identified and managed appropriately.

Rescreening in a year allows for monitoring of any changes without initiating unnecessary treatments or referrals, which might be more appropriate for higher lead levels. Monitoring and education about potential lead exposure sources can be part of the care plan during this time to prevent the risk of elevated levels in the future.

Immediate chelation therapy, on the other hand, is reserved for significantly elevated lead levels, typically 45 mcg/dL or higher, and is not indicated in this case. Monthly follow-up appointments would be excessive and unnecessary given the low lead levels, as would a referral to a pediatric specialist, which is generally not indicated unless there are other complicating factors or higher levels of lead in the blood.