A nurse is caring for a 7-year-old child who was brought in by parents due to unexplained bruising and red spots on the child’s shoulders, thighs, and back.

The parents report that the child has had a cold for more than 2 months and over-the-counter medications have not helped relieve the cold symptoms. The child had a small nosebleed “a few minutes ago” and reports “my arms and legs hurt all over.”. The nurse is reviewing the assessment findings and diagnostic results.

For each assessment finding, specify if the finding is consistent with sickle cell anemia or hemophilia.

Choice A rationale
Iron supplements should not be administered in one large dose every day. High doses can cause side effects such as nausea, vomiting, diarrhea, constipation, and dark stools.
Choice B rationale
Monitoring blood count routinely for several weeks is necessary when a child is taking iron supplements for iron deficiency anemia. This helps to ensure that the supplement is effective and that iron levels are being restored to a healthy range.
Choice C rationale
Iron supplements are not necessarily more effective if administered with meals. In fact, some studies suggest that taking iron supplements with food might decrease the amount of iron absorbed.
Choice D rationale
Restricting fiber from a child’s diet will not necessarily help with the absorption of iron. In fact, a balanced diet, including fiber, is important for overall health.

Choice A rationale
While fat-soluble vitamins are essential for overall health, they do not specifically prevent iron deficiency anemia. Iron deficiency anemia occurs when the body doesn’t have enough iron to produce hemoglobin, the part of red blood cells that gives them their red color and enables them to carry oxygen in the blood.
Choice B rationale
Limiting intake of high-protein foods is not a recommended method for preventing iron deficiency anemia. In fact, many high-protein foods, such as meat and eggs, are good sources of iron.
Choice C rationale
While fluoridated water can help prevent tooth decay, it does not prevent iron deficiency anemia. Iron deficiency anemia is prevented by consuming adequate amounts of iron, either from food sources or from supplements.
Choice D rationale
A diet that consists primarily of milk, particularly cow’s milk, can contribute to iron deficiency anemia. Cow’s milk is low in iron and can also decrease absorption of iron and irritate the lining of the intestine, causing small amounts of bleeding and the gradual loss of iron in the stool (poop)4.