A nurse is caring for a young female adult client who reports weakness, fatigue, and heavy menstrual periods. The client has a hemoglobin level of 8 g/dL and a hematocrit level of 28 g/dL. The nurse suspects which of the following types of anemia?

A. "Yes. Hypertension is prevalent among men; it is fortunate we caught this during your routine examination.": This response is premature as it assumes a diagnosis of hypertension based on a single elevated blood pressure reading without further assessment or confirmation.

B. "We will need to reevaluate your blood pressure because age places you at high risk for hypertension.": While age is a risk factor for hypertension, it is important not to jump to conclusions based on one blood pressure reading. Reevaluation and monitoring are necessary before making any definitive diagnoses or treatment decisions.

C. "A single elevated blood pressure does not confirm hypertension. You will need to have your blood pressure reassessed several times before a diagnosis can be made.": This response is appropriate because it acknowledges the need for further assessment and monitoring before determining if the client has hypertension. It also educates the client about the importance of multiple readings for an accurate diagnosis.

D. "You have no need to worry. Your pressure is probably elevated because you are being tested.": This response dismisses the client's concerns and does not provide accurate information about blood pressure assessment and hypertension diagnosis.

A. Folic acid deficiency anemia:

Folic acid deficiency anemia is characterized by a lack of folate (vitamin B9), which is essential for red blood cell production. Symptoms can include weakness and fatigue, similar to iron-deficiency anemia. However, folic acid deficiency anemia typically does not cause heavy menstrual periods. Laboratory findings may show a low level of folate in the blood, but the hemoglobin level of 8 g/dL and hematocrit level of 28 g/dL alone do not specifically indicate folic acid deficiency anemia without considering other factors like mean corpuscular volume (MCV) and red blood cell indices.

B. Pernicious anemia:

Pernicious anemia is caused by a lack of intrinsic factor, a substance needed for the absorption of vitamin B12. It can lead to symptoms such as weakness and fatigue. However, heavy menstrual periods are not a characteristic feature of pernicious anemia. Laboratory findings may show a low hemoglobin and hematocrit level, but again, other factors such as MCV and vitamin B12 levels would be needed to confirm this type of anemia.

C. Iron-deficiency anemia:

Iron-deficiency anemia occurs due to insufficient iron stores in the body, leading to decreased hemoglobin and hematocrit levels. This type of anemia is commonly associated with symptoms like weakness, fatigue, and heavy menstrual periods in women due to blood loss. The client's hemoglobin level of 8 g/dL and hematocrit level of 28 g/dL are consistent with iron-deficiency anemia, making this the most likely choice based on the information provided.

D. Sickle cell anemia:

Sickle cell anemia is a genetic disorder characterized by abnormal hemoglobin that causes red blood cells to become sickle-shaped and less flexible. It typically presents with symptoms such as anemia, pain crises, and organ damage. However, the client's symptoms of weakness, fatigue, and heavy menstrual periods are not specific to sickle cell anemia. Additionally, sickle cell anemia would have different laboratory findings, including a different pattern on peripheral blood smear and hemoglobin electrophoresis.