The nurse notes that there is a difference in a patient's blood pressure (BP) and heart rate (HR) when the patient changes position from supine to standing. The differences are a decrease of 20 mm Hg in systolic BP, a decrease of 10 mm Hg in diastolic BP, and an increase in the HR of 20 beats/minute.
Which interpretation would the nurse make about the patient's condition?

Choice A rationale:

Enteric-coated iron is designed to be absorbed in the small intestine, not the stomach. Taking it with each meal might decrease its absorption due to interaction with food.

Choice B rationale:

Cobalamin (vitamin B12) deficiency can cause macrocytic anemia, not microcytic hypochromic anemia. Taking cobalamin with green, leafy vegetables does not address the specific iron deficiency seen in microcytic hypochromic anemia.

Choice C rationale:

Take the iron with orange juice 1 hour before meals is the correct answer. Vitamin C enhances the absorption of non-heme iron (the type of iron found in plant-based foods and iron supplements) by reducing it to a more absorbable form. Taking iron supplements with orange juice, which is high in vitamin C, can significantly improve iron absorption. Taking it before meals ensures better absorption due to reduced interaction with other dietary components.

Choice D rationale:

Decreasing the intake of antiseizure medications will not improve microcytic hypochromic anemia. Antiseizure medications do not directly influence iron absorption or the production of red blood cells.

Choice A rationale:

Increased bilirubin levels can occur in thalassemia major due to the destruction of red blood cells, leading to elevated bilirubin, which is a breakdown product of hemoglobin. This elevation can contribute to jaundice and other symptoms.

Choice B rationale:

Thalassemia major leads to the destruction of red blood cells, causing the bone marrow to release more reticulocytes (immature red blood cells) into the bloodstream. Therefore, an increased reticulocyte level is expected in thalassemia major.

Choice C rationale:

Increased mean corpuscular volume (MCV) is not a typical finding in thalassemia major. Thalassemia major is characterized by microcytic (smaller than normal) red blood cells, leading to a decreased MCV.

Choice D rationale:

Thalassemia major causes increased iron absorption by the intestines, leading to elevated total iron-binding capacity (TIBC) TIBC measures the body's capacity to bind and transport iron in the blood, and elevated levels are seen in conditions with increased iron demand, such as thalassemia major.