A patient who is 38 weeks pregnant is admitted to the hospital in active labor.
On admission, the patient says, “For the past ten hours, I have been leaking small amounts of urine.” Which action should the nurse take initially?

The correct answer is choice D. Orange juice.This is because orange juice is rich in vitamin C, which enhances the absorption of iron from ferrous sulfate tablets.Vitamin C helps reduce iron to its ferrous form, which is more readily absorbed by the intestinal cells.

Choice A is wrong because milk contains calcium, which inhibits iron absorption by forming insoluble complexes with iron.Choice

B is wrong because tea contains tannins, which are polyphenols that bind to iron and decrease its bioavailability.Choice C is wrong because water does not have any effect on iron absorption, neither enhancing nor inhibiting it.

Normal ranges for serum iron are 50-170 mcg/dL for men and 40-150 mcg/dL for women.Normal ranges for hemoglobin are 13.5-17.5 g/dL for men and 12-15.5 g/dL for women.

Physiologic jaundice is a common condition in newborns that occurs when the baby’s blood contains an excess of bilirubin, a yellow pigment produced during the normal breakdown of red blood cells.In the womb, the mother’s liver removes bilirubin for the baby, but after birth the baby’s own liver must take over this function.Because the baby has more red blood cells than an adult and their liver is still immature, they may not be able to process all the bilirubin and it may build up in their skin and eyes, causing a yellowish appearance.

Choice A is wrong because it is not an increase in neonatal metabolism that causes physiologic jaundice, but rather a decrease in hepatic metabolism of bilirubin.

Choice C is wrong because it describes a different type of jaundice called hemolytic jaundice, which occurs when there is an incompatibility between the blood types of the mother and the baby, leading to an immune reaction that destroys the baby’s red blood cells faster than they can be replaced.

Choice D is wrong because it confuses the reticuloendothelial system with the hepatic system.

The reticuloendothelial system is a network of cells and tissues that are involved in immune responses and phagocytosis (the ingestion of foreign particles or cells).

The hepatic system is the system of organs and structures that are involved in liver functions, such as bile production and detoxification.

Normal ranges for bilirubin levels in newborns are 1 to 12 mg/dL (17 to 205 micromol/L) for total bilirubin and 0.2 to 1.4 mg/dL (3 to 24 micromol/L) for direct bilirubin.

Physiologic jaundice usually peaks at 3 to 5 days after birth and resolves by 2 weeks of age.

It does not require treatment unless the bilirubin levels are very high or rising rapidly, which may indicate a more serious condition or a risk of brain damage.