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The nurse is caring for the client who has iron deficiency anemia.

Which of the following instructions should the nurse include? Select all that apply.

Increase sources of fiber in the diet.

Take an antacid within 30 min after medication administration.

Increase intake of milk and dairy products.

Take the medication with a source of vitamin C.

Take the medication on an empty stomach.

Answer and Explanation

Correct Answer : A,D,E

Increase sources of fiber in the diet: Increasing dietary fiber is important for maintaining bowel health, especially when taking iron supplements, as constipation is a common side effect of iron therapy. A higher fiber intake can help alleviate constipation and promote regular bowel movements.
Take the medication with a source of vitamin C: Vitamin C enhances iron absorption in the gastrointestinal tract. Clients should be instructed to take ferrous sulfate with vitamin C-rich foods (such as citrus fruits) or beverages (like orange juice) to maximize absorption and improve the effectiveness of the iron supplement.
Take the medication on an empty stomach: Iron supplements are best absorbed when taken on an empty stomach, ideally 1 hour before or 2 hours after meals. However, if gastrointestinal upset occurs, the client may take the medication with food to minimize discomfort, but this can reduce absorption.

Take an antacid within 30 min after medication administration: Antacids can interfere with the absorption of iron supplements. Clients should be advised to avoid antacids for at least 2 hours before or after taking iron supplements to ensure proper absorption.
Increase intake of milk and dairy products: Calcium in milk and dairy products can inhibit iron absorption when consumed simultaneously. Clients should be advised to avoid consuming these products around the time they take their iron supplement for optimal absorption.

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Free Nursing Study Resources

Correct Answer is {"A":{"answers":"B"},"B":{"answers":"B"},"C":{"answers":"C"},"D":{"answers":"C"},"E":{"answers":"C"},"F":{"answers":"C"}}

Explanation

Indication of potential improvement:
• Shortness of breath with exertion
• Lung sounds clear

Indication of potential worsening condition:
• WBC count 11,800/mm³
• Temperature 38.5°C (101.3°F)
• Weight 113 kg (249 lb)
• Creatinine 1.8 mg/dL

Rationale:

• Shortness of breath with exertion: Previously, the client had dyspnea at rest. Improvement to exertional dyspnea suggests better fluid balance and cardiac function.

• Lung sounds clear: The initial presence of crackles indicated pulmonary congestion. Clear lung sounds suggest reduced fluid overload, reflecting improved cardiac function.

• WBC count 11,800/mm³: An increasing WBC count suggests a possible infection, which can worsen heart failure by increasing metabolic demands and fluid retention.

• Temperature 38.5°C (101.3°F): Fever indicates a possible infection, such as a UTI, which the client has a history of. Infections can exacerbate heart failure by triggering systemic inflammation and fluid shifts.

• Weight 113 kg (249 lb): Weight gain in heart failure is often due to fluid retention, indicating worsening congestion.

• Creatinine 1.8 mg/dL: A rising creatinine level suggests worsening kidney function, which may result from reduced perfusion due to heart failure or excessive diuresis from furosemide.

A. Metoprolol 5 mg every 2 to 3 min up to three doses B. Oxygen at 2 L/min via nasal cannula C. Draw electrolytes along with Hgb and Hct D. Morphine 6 mg IV bolus every 3 hr as needed for pain E. Nitroglycerin 0.4 mg SL now may repeat every 5 min up to 3 doses F. Obtain daily weight G. Atropine 0.5 mg IV bolus every 5 min up to 2 mg

Correct Answer is {"A":{"answers":"A"},"B":{"answers":"A"},"C":{"answers":"A"},"D":{"answers":"A"},"E":{"answers":"A"},"F":{"answers":"B"},"G":{"answers":"C"}}

Explanation

Anticipated:

Metoprolol 5 mg every 2 to 3 min up to three doses
Oxygen at 2 L/min via nasal cannula
Draw electrolytes along with Hgb and Hct
Morphine 6 mg IV bolus every 3 hr as needed for pain
Nitroglycerin 0.4 mg SL now may repeat every 5 min up to 3 doses

Nonessential:

Obtain daily weight

Contraindicated:

Atropine 0.5 mg IV bolus every 5 min up to 2 mg

Rationale:

Metoprolol 5 mg every 2 to 3 min up to three doses: Beta-blockers reduce myocardial oxygen demand by decreasing heart rate and blood pressure, making them beneficial in acute coronary syndrome. They should be used cautiously in patients with signs of heart failure or bradycardia.
Oxygen at 2 L/min via nasal cannula: Supplemental oxygen is recommended for clients with acute coronary syndrome when oxygen saturation is below 94% to optimize myocardial oxygen supply and prevent ischemia.
Draw electrolytes along with Hgb and Hct: Electrolytes are critical in evaluating myocardial function, and hemoglobin/hematocrit levels help assess perfusion and oxygen-carrying capacity.
Morphine 6 mg IV bolus every 3 hr as needed for pain: Morphine is used to relieve severe chest pain in myocardial infarction and reduce myocardial oxygen demand by decreasing anxiety and preload.
Nitroglycerin 0.4 mg SL now may repeat every 5 min up to 3 doses: Nitroglycerin dilates coronary arteries, improving oxygen delivery to the myocardium, and reduces preload and afterload, alleviating chest pain. It is a first-line treatment for angina and myocardial infarction but should be avoided in cases of hypotension.
Obtain daily weight: Daily weight monitoring is primarily used for fluid balance assessment in conditions like heart failure rather than for acute myocardial infarction management.
Atropine 0.5 mg IV bolus every 5 min up to 2 mg: Atropine is used to treat bradycardia. However, the client is tachycardic, so atropine would worsen the condition and is contraindicated.

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The nurse is caring for the client who has iron deficiency anemia. Which of the following instructions should the nurse include? Select all that apply.

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who is experiencing an exacerbation of heart failure. Findings upon admission: The nurse is assessing the client 24 hr later. How should the nurse interpret the findings related to the diagnosis of heart failure?

Correct Answer is {"A":{"answers":"B"},"B":{"answers":"B"},"C":{"answers":"C"},"D":{"answers":"C"},"E":{"answers":"C"},"F":{"answers":"C"}}

Explanation

The nurse is reviewing the client's medical record. For each potential provider's prescription, click to specify if the potential prescription is anticipated, nonessential, or contraindicated for the client.

Correct Answer is {"A":{"answers":"A"},"B":{"answers":"A"},"C":{"answers":"A"},"D":{"answers":"A"},"E":{"answers":"A"},"F":{"answers":"B"},"G":{"answers":"C"}}

Explanation

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The nurse is caring for the client who has iron deficiency anemia.

Which of the following instructions should the nurse include? Select all that apply.