A nurse is collecting data from a newborn who weighs 5,160 g (11 lb, 6 oz) and whose mother has diabetes mellitus. For which of the following data should the nurse monitor?

Choice A rationale :

Scrambled eggs. Taking ferrous sulfate with scrambled eggs is not the optimal choice because eggs contain phytates, which can bind to iron and reduce its absorption. Therefore, it may hinder the effectiveness of the iron supplement, and the client may not receive the full benefit of the medication.

Choice B rationale

A high-fibre meal. While fiber is generally beneficial for digestion and overall health, it is not the best choice to take with ferrous sulfate. Fiber can also interfere with iron absorption in the same way as phytates, potentially reducing the medication's effectiveness.

Choice C rationale

Orange juice. The nurse should instruct the client to take the ferrous sulfate with orange juice. Orange juice is an excellent choice because it is rich in vitamin C. Vitamin C enhances the absorption of non-heme iron (the type of iron found in plant-based sources like ferrous sulfate). By taking the medication with orange juice, the client can maximize the absorption of iron and improve the treatment of iron-deficiency anaemia.

Choice D rationale

Milk. Consuming ferrous sulfate with milk is not advisable. Calcium, present in milk, can inhibit the absorption of iron. Therefore, taking the medication with milk might reduce the efficacy of the iron supplement and not provide the desired therapeutic effect.

Choice A reason:
Initiating epidural anesthesia too soon may delay rupture of fetal membranes. This statement is not accurate. Epidural anesthesia itself does not have a direct impact on the rupture of fetal membranes. The timing of rupturing membranes is determined based on the progress of labor and other clinical indications. There is no causal relationship between epidural anesthesia and the timing of membrane rupture.

Choice B reason:
Initiating epidural anesthesia too soon can prolong labor. This statement is correct. Epidural anesthesia, while providing pain relief during labor, can also cause some degree of motor blockage and decrease the woman's ability to push effectively. This can potentially lead to a lengthening of the labor process. It is generally recommended to wait until a good labor pattern has been established to avoid unnecessary prolongation of labor.

Choice C reason:
Initiating epidural anesthesia too soon can cause fetal depression. This statement is not entirely accurate. Epidural anesthesia can cross the placenta and reach the fetus, but the effect on the baby is usually minimal. However, fetal monitoring is essential during labor to ensure the baby's well-being, regardless of whether epidural anesthesia is used or not.

Choice D reason:
Initiating epidural anesthesia too soon can cause maternal hypertension. This statement is not supported by evidence. Epidural anesthesia does not typically cause maternal hypertension. It can, however, lead to a decrease in blood pressure in some cases, which is why careful monitoring of maternal blood pressure is necessary during and after the administration of epidural anesthesia.