A pregnant woman in the first trimester of pregnancy has a hemoglobin of 8.6 g/dL (86 g/L) and a hematocrit of 25.1% (0.25 volume fraction). Which food should the practical nurse (PN) encourage this client to include in her diet? Reference Range: Hemoglobin, pregnant female [greater than 11 g/dL (greater than 110 g/L)] Hematocrit, pregnant female [greater than 33% (greater than 0.33 volume fraction)]

Choice A rationale

Sweet potatoes are a gluten-free root vegetable. They are rich in vitamins, minerals, and fiber, and their consumption is safe for individuals with celiac disease or gluten sensitivity. The presence of antigliadin and antiendomysial antibodies indicates a gluten-related disorder, necessitating avoidance of gluten-containing grains, not sweet potatoes.

Choice B rationale

Wheat bread contains gluten, a protein complex found in wheat, barley, and rye. Antigliadin and antiendomysial antibodies are serological markers for celiac disease, an autoimmune disorder triggered by gluten ingestion, leading to small intestinal damage. Therefore, individuals with these antibodies must avoid gluten-containing foods like wheat bread to prevent symptomatic flares and intestinal damage.

Choice C rationale

Orange juice is a gluten-free beverage, primarily composed of water, sugars, and vitamins. It does not contain any gluten-derived proteins. Its consumption is safe for individuals with celiac disease or gluten sensitivity, as it will not elicit an immune response or contribute to intestinal damage in those with antigliadin and antiendomysial antibodies.

Choice D rationale

Swiss cheese is a dairy product and naturally gluten-free. It consists primarily of milk proteins, fats, and calcium, with no gluten-containing grains. Individuals with celiac disease or gluten sensitivity can safely consume Swiss cheese without triggering an immune response, as it does not contain the specific proteins that activate antigliadin and antiendomysial antibodies.

Choice A rationale

Cheese is a good source of calcium and protein, but it is not a primary source of iron. Iron is essential for hemoglobin synthesis, and the client's hemoglobin and hematocrit levels are below normal ranges [Hemoglobin, pregnant female > 11 g/dL ( > 110 g/L); Hematocrit, pregnant female > 33% ( > 0.33 volume fraction)], indicating iron deficiency anemia.

Choice B rationale

Cauliflower is a cruciferous vegetable rich in vitamin C and fiber, but its iron content is relatively low. While vitamin C aids in iron absorption, cauliflower itself does not provide a significant amount of dietary iron to effectively address the client's anemic status.

Choice C rationale

Carrots are well-known for their beta-carotene content, a precursor to vitamin A, and provide fiber. However, carrots are not a significant source of iron. To combat iron deficiency anemia during pregnancy, foods rich in heme iron or non-heme iron with good bioavailability are required.

Choice D rationale

Chicken, particularly the dark meat, is a good source of heme iron, which is more readily absorbed by the body compared to non-heme iron found in plant-based foods. Given the client's anemic status, increasing dietary intake of iron-rich foods like chicken is crucial for improving hemoglobin and hematocrit levels.