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 intake of milk and dairy products.

Take an antacid within 30 min after medication administration.

Take the medication on an empty stomach.

Increase sources of fiber in the diet.

Take the medication with a source of vitamin C.

Answer and Explanation

Correct Answer : C,D,E

Iron deficiency anemia occurs when the body has inadequate iron stores to produce sufficient hemoglobin for oxygen transport. Clients commonly present with fatigue, weakness, pallor, tachycardia, and exertional shortness of breath due to reduced oxygen-carrying capacity. Oral iron therapy with Ferrous sulfate is the standard treatment, but proper administration and dietary teaching are necessary to improve absorption and reduce adverse effects. Nursing education helps ensure effective treatment and prevention of recurrence.

A. Increasing intake of milk and dairy products is not recommended when taking iron supplements because calcium interferes with iron absorption in the gastrointestinal tract. Dairy products can reduce the effectiveness of oral iron therapy if taken close to the medication time. The client should separate calcium-rich foods from iron administration.

B. Taking an antacid within 30 minutes after medication administration is incorrect because antacids decrease gastric acidity, which is needed for optimal iron absorption. Reduced stomach acidity limits the conversion of iron into its absorbable form. Antacids should be avoided close to the time of iron supplementation.

C. Taking the medication on an empty stomach is correct because iron is absorbed best in an acidic gastric environment without interference from food. Although some clients may need to take it with food if gastrointestinal upset occurs, the preferred teaching is to take it before meals for maximum absorption.

D. Increasing sources of fiber in the diet is appropriate because iron supplements commonly cause constipation as a side effect. Adding fiber-rich foods such as fruits, vegetables, legumes, and whole grains helps promote bowel regularity and reduces discomfort associated with therapy. Adequate fluid intake should also be encouraged.

E. Taking the medication with a source of vitamin C is correct because vitamin C enhances the absorption of non-heme iron by converting it into a more absorbable form. Drinking orange juice or consuming citrus fruits with iron supplements improves therapeutic effectiveness and supports correction of anemia.

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Correct Answer is D

Explanation

Mannitol is an osmotic diuretic commonly used in clients with head injuries to reduce intracranial pressure by drawing fluid from cerebral tissues into the intravascular space. While it is effective in lowering intracranial pressure, it can significantly increase circulating fluid volume. This shift places clients at risk for fluid overload and pulmonary complications. Careful monitoring of respiratory status and fluid balance is essential during therapy.

A. An intracranial pressure (ICP) reading of 12 mm Hg is within the expected normal range (5–15 mm Hg) and indicates that the medication is achieving its therapeutic goal. Mannitol is used to lower ICP, so this value reflects effective treatment rather than an adverse effect requiring intervention.

B. Increased urinary output is an expected therapeutic effect of mannitol because it works by pulling fluid into the bloodstream and promoting renal excretion. This diuresis helps reduce intracranial pressure and is not considered an adverse effect unless it becomes excessive and leads to dehydration or electrolyte imbalance.

C. A Glasgow Coma Scale score of 15 indicates that the client is fully alert and oriented with no neurological deterioration. This is the best possible score and reflects normal neurological function rather than a complication of therapy.

D. Crackles on auscultation indicate pulmonary fluid overload, which is a serious adverse effect of mannitol therapy. Because mannitol increases intravascular volume, it can precipitate pulmonary edema and impaired gas exchange. This finding must be reported immediately to the provider for prompt intervention.

A. "Eat a light meal 1 hour before bedtime." B. "Increase your caloric intake by 250 calories per day." C. “Sleep with the head of your bed elevated 6 inches." D. "Lie down for 30 minutes after each meal."

Correct Answer is C

Explanation

Gastroesophageal reflux disease (GERD) occurs when gastric contents flow backward into the esophagus due to relaxation or weakness of the lower esophageal sphincter. This causes symptoms such as heartburn, regurgitation, and chest discomfort, especially after meals or when lying flat. Management includes lifestyle modifications aimed at reducing reflux episodes and protecting the esophageal lining. Patient teaching is essential to prevent symptom worsening and long-term complications.

A. Eating a light meal 1 hour before bedtime is not recommended because lying down soon after eating increases the risk of reflux. Clients with GERD should avoid eating for at least 2 to 3 hours before bedtime to reduce nighttime symptoms. Even a light meal can stimulate acid production and worsen reflux when taken too close to sleep.

B. Increasing caloric intake by 250 calories per day is not a standard recommendation for GERD management. In fact, weight reduction is often encouraged in overweight clients because excess abdominal pressure worsens reflux. The goal is symptom control through dietary timing and food choices rather than increasing caloric intake.

C. Sleeping with the head of the bed elevated 6 inches is an effective nonpharmacological intervention for GERD. Elevation uses gravity to help prevent gastric contents from refluxing into the esophagus during sleep. This reduces nighttime heartburn, regurgitation, and irritation of the esophageal mucosa.

D. Lying down for 30 minutes after each meal is contraindicated because it promotes reflux by allowing stomach contents to move more easily into the esophagus. Clients should remain upright after meals and avoid bending over or reclining. Upright positioning improves gastric emptying and reduces symptom severity.

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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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Correct Answer is D

Explanation

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Correct Answer is C

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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.