A 4-year-old child diagnosed with iron deficiency anemia is prescribed oral ferrous sulfate. The child's parents report difficulty administering the medication due to gastrointestinal side effects and poor adherence. Which nursing action is most appropriate to enhance the effectiveness of treatment and minimize complications?
Instruct the parents to administer the iron supplement with vitamin C-rich juice and on an empty stomach to improve absorption, while monitoring for side effects.
Advise the parents to give the iron supplement with milk to reduce gastrointestinal upset and enhance tolerance.
Recommend switching to intravenous iron therapy immediately to avoid gastrointestinal side effects and ensure compliance.
Suggest stopping the iron supplement temporarily until the child's hemoglobin normalizes, then restart to avoid side effects.
The Correct Answer is A
A. Instruct the parents to administer the iron supplement with vitamin C-rich juice and on an empty stomach to improve absorption, while monitoring for side effects is correct because vitamin C enhances the absorption of non-heme iron, and taking iron on an empty stomach increases bioavailability. While gastrointestinal side effects such as constipation, nausea, and abdominal discomfort may occur, they can be managed through dosing adjustments, timing, and dietary measures rather than discontinuing therapy. Monitoring for side effects ensures safety and adherence.
B. Advise the parents to give the iron supplement with milk to reduce gastrointestinal upset and enhance tolerance is incorrect because milk and dairy products contain calcium, which inhibits iron absorption. Administering iron with milk can significantly reduce the effectiveness of treatment and delay correction of anemia.
C. Recommend switching to intravenous iron therapy immediately to avoid gastrointestinal side effects and ensure compliance is incorrect because oral iron is first-line therapy for children with iron deficiency anemia. IV iron is reserved for cases where oral iron is ineffective, not tolerated, or in malabsorption disorders, due to the risk of serious side effects and cost.
D. Suggest stopping the iron supplement temporarily until the child's hemoglobin normalizes, then restart to avoid side effects is incorrect because interrupting therapy prevents replenishment of iron stores and prolongs anemia. Consistent administration with proper strategies to manage side effects is safer and more effective.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Oral agents are often effective for treatment is incorrect because type 1 diabetes is characterized by autoimmune destruction of pancreatic beta cells, leading to absolute insulin deficiency. Insulin therapy, not oral hypoglycemic agents, is required.
B. Age at onset is usually younger than 18 years is correct because immune-mediated type 1 diabetes typically develops in children and adolescents, although it can occur at any age. This is the classic age group for presentation of type 1 diabetes.
C. Onset is gradual is incorrect because type 1 diabetes usually has a rapid onset of symptoms, such as polyuria, polydipsia, weight loss, and fatigue, over weeks to months.
D. Ketoacidosis is infrequent is incorrect because diabetic ketoacidosis (DKA) is a common presenting feature in children with type 1 diabetes, especially at initial diagnosis, due to absolute insulin deficiency.
Correct Answer is ["A","C","E"]
Explanation
A. Expression of bedtime fears is common is correct because toddlers commonly experience fears related to separation, darkness, or unfamiliar situations. These fears are a normal part of emotional and cognitive development and should be addressed with reassurance and consistent routines.
B. Importance of annual screenings for phenylketonuria is incorrect because PKU screening is performed at birth through newborn screening. Routine annual screening is not part of anticipatory guidance for toddlers.
C. Develop food habits that will prevent dental caries is correct because toddlers are at increased risk for dental caries. Guidance should include limiting sugary foods and drinks, avoiding bedtime bottles with milk or juice, and promoting good oral hygiene habits.
D. Significance of potty training by 18 months is incorrect because readiness for toilet training varies widely. Most toddlers are not developmentally ready until 18–24 months or later, and forcing early training can lead to frustration and setbacks.
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