A nurse is developing a care plan for a client with disseminated intravascular coagulation (DIC). Which nursing intervention should the nurse include?

Administer aspirin daily as ordered

Place a pressure-reducing mattress on the client’s bed

Administer meperidine (Demerol) intramuscularly as needed for pain

Provide mouth care every 4 hours with lemon-glycerin swabs

Answer and Explanation

The Correct Answer is B

Reasoning:

Choice A reason: Administering aspirin is contraindicated in DIC, as it inhibits platelet function, worsening bleeding risk in a condition already characterized by thrombocytopenia and coagulopathy. Aspirin’s antiplatelet effect could exacerbate hemorrhage, making it an inappropriate intervention for a client with active DIC-related bleeding tendencies.

Choice B reason: Placing a pressure-reducing mattress is appropriate in DIC to prevent skin breakdown, as clients are at risk for bleeding and bruising due to low platelets and coagulopathy. Immobility from critical illness increases pressure injury risk, and a specialized mattress minimizes tissue damage and supports skin integrity.

Choice C reason: Administering meperidine intramuscularly is inappropriate in DIC, as intramuscular injections can cause hematomas due to low platelets and impaired clotting. Pain management in DIC should use intravenous or oral routes to avoid bleeding complications, making this intervention unsafe for the client’s condition.

Choice D reason: Lemon-glycerin swabs for mouth care are not ideal in DIC, as they can dry mucous membranes, increasing bleeding risk in thrombocytopenic clients. Gentle oral care with saline or soft brushes is preferred to maintain mucosal integrity, making this intervention less appropriate for DIC management.

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Correct Answer is A

Explanation

Reasoning:

Choice A reason: Bleeding, particularly gastrointestinal, is the most common cause of iron deficiency anemia in males and postmenopausal females. Blood loss reduces iron stores, as hemoglobin contains iron, and chronic bleeding (e.g., from ulcers or colon cancer) depletes iron faster than dietary intake can replenish, leading to anemia.

Choice B reason: Chronic alcohol use may contribute to anemia through nutritional deficiencies or liver disease, but it is not the primary cause. Alcohol can impair folate metabolism or cause gastrointestinal bleeding, but direct blood loss is a more common and significant driver of iron deficiency in these populations.

Choice C reason: Menorrhagia, or heavy menstrual bleeding, is a common cause of iron deficiency anemia in premenopausal women, not males or postmenopausal females. After menopause, menstruation ceases, eliminating this as a cause, making bleeding from other sources, like the gastrointestinal tract, more relevant.

Choice D reason: Iron malabsorption, as in celiac disease or gastric surgery, can cause iron deficiency but is less common than bleeding. Malabsorption impairs dietary iron uptake, but chronic blood loss, especially from gastrointestinal sources, is the leading cause in males and postmenopausal females due to higher prevalence.

A. Beef liver accompanied by orange juice B. Yogurt, almonds, and whole grain oats C. Salmon accompanied by whole milk D. Mixed vegetables and brown rice

Correct Answer is A

Explanation

Reasoning:

Choice A reason: Beef liver is rich in heme iron, highly bioavailable for hemoglobin synthesis, and orange juice provides vitamin C, enhancing non-heme iron absorption. This combination maximizes iron uptake, critical for correcting iron deficiency anemia in pregnancy, where iron demands increase due to fetal growth and maternal blood volume expansion.

Choice B reason: Yogurt, almonds, and oats contain non-heme iron, but their bioavailability is lower than heme iron from meat. Calcium in yogurt may inhibit iron absorption, and while nutritious, this combination is less effective for rapidly increasing iron stores in iron deficiency anemia during pregnancy.

Choice C reason: Salmon and whole milk provide protein and calcium but are poor sources of iron. Salmon has minimal iron, and milk’s calcium can inhibit iron absorption. This combination does not effectively address the increased iron needs of pregnancy-related iron deficiency anemia, making it less suitable.

Choice D reason: Mixed vegetables and brown rice contain non-heme iron, but absorption is limited compared to heme iron sources. Without vitamin C to enhance uptake, this combination is less effective for correcting iron deficiency anemia in pregnancy, where rapid restoration of iron stores is critical.

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A nurse is developing a care plan for a client with disseminated intravascular coagulation (DIC). Which nursing intervention should the nurse include?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The most common cause of iron deficiency anemia in male clients and postmenopausal female clients is:

Correct Answer is A

Explanation

A client who is in the third trimester of pregnancy has been experiencing an exacerbation of iron-deficiency anemia in recent weeks. When providing the client with nutritional guidelines and meal suggestions, what foods would be most likely to increase the client’s iron stores?

Correct Answer is A

Explanation

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