Which foods will the nurse recommend to a client with iron deficiency anemia select all that apply one some or all responses may be correct quizlet?

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  • Which foods will the nurse recommend to a client with iron deficiency anemia?
  • What foods treat iron deficiency anemia?
  • Which food should the nurse recommend for a child with iron deficiency anemia?
  • What type of food will you advice to her in order to treat her anemia?

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Terms in this set (29)

A patient with anemia receives a new prescription for oral iron supplements. What should the nurse include in the medication education related to improving the absorption of the supplement?

1 "Take it with meals."
2 "Take it one hour after eating."
3 "Take it one hour before breakfast, with orange juice."
4 "Take it on an empty stomach with a full glass of water."

3
Iron is absorbed best as ferrous sulfate in an acidic environment. For this reason and to avoid binding the iron with food, iron should be taken about an hour before meals, when the duodenal mucosa is most acidic. Taking iron with vitamin C (ascorbic acid) or orange juice, which contains ascorbic acid, enhances iron absorption. Gastric side effects, however, may necessitate ingesting iron with meals.

A patient's laboratory reports show a low mean corpuscular volume (MCV) and a high reticulocyte count. The nurse suspects which condition?

1 Thalassemia
2 Hemolytic anemia
3 Sickle cell anemia
4 Folic acid deficiency

1
In thalassemia, a low mean corpuscular volume and a high reticulocyte count are observed. In sickle cell anemia, a normal MCV and low reticulocyte count are seen. In hemolytic anemia, a normal MCV and increased reticulocytes are found. An increased MCV and normal or low reticulocyte count occur due to a folic acid deficiency.

The nurse recalls that which condition is characterized by the presence of a high percentage of Hgb S in the erythrocytes?

1 Thalassemia
2 Aplastic anemia
3 Sickle cell disease
4 Acquired hemolytic anemia

3
Sickle cell disease is characterized by the presence of a high percentage of Hgb S in the erythrocytes. Thalassemia occurs due to the absence of reduced globulin protein. Aplastic anemia is a disease characterized by pancytopenia in which all the blood cell types decrease. Acquired hemolytic anemia results from hemolysis of RBCs from extrinsic factors. It is characterized by increased MCV, reticulocytes, and bilirubin.

The nurse assesses a patient with pernicious anemia and expects to find what classic sign of this condition?

1 Diarrhea
2 Indigestion
3 Flushed skin
4 Red, beefy tongue

4
The decreased absorption of vitamin B12 resulting from a lack of intrinsic factor causes a decrease in hemoglobin, hematocrit, and red blood cells. A smooth, red, enlarged or "beefy" appearance of the tongue may also be seen. Intrinsic factor is produced by the parietal cells of the stomach lining and is required to absorb vitamin B12 from the intestines. Causes of decreased intrinsic factor production include surgical alterations such as gastrectomy and autoimmune disease. Diarrhea, indigestion, and flushed skin appearance are not signs specifically associated with pernicious anemia.

A patient with anemia experiences fatigue when performing activities of daily living. Which nursing intervention is appropriate to include in the patient's plan of care?

1 Encourage frequent visitors.
2 Assist the patient in prioritizing activities.
3 Assist the patient in walking immediately after meals.
4 Ensure that all physical activities are completed in the morning

2
The nurse should teach and assist the patient and caregiver to assign priority to activities to accommodate energy levels and promote tolerance for important activities. The patient should be asked to avoid activity immediately after meals to reduce competition for oxygen supply to vital functions. Activities should be alternated with rest periods throughout the day rather than completed in the morning. The caregiver should limit the number of visitors so that the patient receives adequate rest.

The nurse provides teaching to a patient who receives a prescription for an iron supplement. What should the nurse include in the education?

1 Take the iron supplement with food
2 Dilute the liquid iron and ingest it through a straw
3 Refrain from drinking orange juice when taking iron
4 Refrain from the use of laxatives when on iron therapy

2
Undiluted liquid iron may stain the patient's teeth; therefore liquid iron should be diluted and ingested through a straw. Iron is best absorbed as ferrous sulfate (Fe2+) in an acidic environment. Therefore iron supplements should be taken about an hour before meals when the duodenal mucosa is acidic. Orange juice contains vitamin C (ascorbic acid), which enhances iron absorption. Therefore it is advisable to take vitamin C supplements along with iron. Constipation may occur commonly in patients who are prescribed iron therapy. Therefore it is advisable to take laxatives and stool softeners when receiving iron therapy.

The nurse recalls that the standard of care for pain includes what component?

1 That the pain assessment is based on nursing judgment
2 The minimal amount of intervention required to address pain
3 That competent and compassionate care is provided to all patients
4 Notifying the health care provider regarding the effects of the pain medication

3
The standard of care for pain includes providing competent and compassionate care for all patients. The patient's pain assessment is not based on nursing judgment; it is based on the patient's self report. The standard of care for pain includes providing the best possible relief under the circumstances. Notifying the health care provider regarding the effects of the pain medication should occur if the medication is not providing adequate pain relief for the patient.

A patient has a hemoglobin level of 11 g/dL. The nurse determines that the patient has what level of severity of anemia?

1 Mild anemia
2 Severe anemia
3 Aplastic anemia
4 Moderate anemia

1
In mild anemia, hemoglobin is in the range of 10-12 g/dL. Aplastic anemia refers to a type of anemia caused by a decrease in red blood cell precursors. It does not refer to the severity of anemia. In severe anemia, it is less than 6 g/dL. In moderate anemia, the hemoglobin it is in the range of 6-10 g/dL. Hemoglobin above 12 g/dL is considered normal (no anemia).

A patient is scheduled to receive a transfusion of two units of packed red blood cells. The nurse would ask which health team member to assist in checking the unit before administration?

1 The unit secretary
2 The physician's assistant
3 Another registered nurse (RN)
4 The unlicensed assistive personnel (UAP)

3
Before hanging a transfusion, the registered nurse must check the unit with another RN or with a licensed practical (vocational) nurse, depending on agency policy. If there is not another nurse available, a health care provider could check the blood with the nurse. The unit secretary and UAP are not licensed to perform this duty.

The nurse recalls that the role of folic acid in erythropoiesis is what?

1 Aids in absorption of iron
2 Promotes RBC maturation
3 Promotes hemoglobin synthesis
4 Aids in mobilization of iron from tissue to plasma

2
Folic acid promotes maturation of red blood cells (RBC). Ascorbic acid aids in the absorption of iron. Iron and pyridoxine promote hemoglobin synthesis. Copper helps in the mobilization of iron from tissue to plasma.

The nurse reviews documentation of assessment findings of a patient with severe anemia. The nurse should question which assessment finding?

1 Pallor
2 Pruritus
3 Jaundice
4 Hyperpigmentation

4
Common integumentary changes observed in anemia include pallor, jaundice, and pruritus. Pallor results from reduced amounts of hemoglobin and reduced blood flow to the skin. Jaundice occurs when hemolysis of RBCs results in an increased concentration of serum bilirubin. Pruritus occurs because of increased serum and skin bile salt concentration. Hyperpigmentation is usually not associated with anemia.

To prepare for a patient's transfusion of packed red blood cells, the nurse should select which intravenous solution to use for the procedure?

1 3% normal saline
2 Lactated Ringer's
3 5% dextrose in water
4 0.9% normal saline

4
The blood set should be primed before the transfusion with 0.9% sodium chloride, also known as normal saline. It is also used to flush the blood tubing after the infusion is complete to ensure the patient receives blood that is left in the tubing when the bag is empty. Lactated Ringer's, 5% dextrose in water, and 3% normal saline are not compatible with blood products.

A patient receives a new prescription for a transfusion of two units of packed red blood cells (PRBCs). The nurse should take which action to ensure patient safety?

1 Add the blood transfusion as a secondary line to the existing IV and infuse over 60 minutes or less.
2 Remain with the patient for 60 minutes after beginning the transfusion to watch for signs of transfusion reaction.
3 Select a new primary intravenous (IV) tubing to use for the administration and piggyback with 500 mL of normal saline.
4 Have a second registered nurse check the identifying information on the unit of blood against the identification bracelet and blood-bank identification bracelet

4
The patient's identifying information (name, date of birth, medical record number) on the identification bracelet should match exactly the information on the blood-bank tag that has been placed on the unit of blood. If any information does not match, the transfusion should not be hung because of possible error and risk to the patient. Blood tubing, not primary tubing, is needed for blood transfusion and should not be administered as a secondary infusion. The nurse should remain with the patient for 15 minutes following initiation of transfusion.

A patient receives a prescription for ferrous gluconate. The nurse should provide education related to what potential side effect?

1 Hypotension
2 Constipation
3 Clay-colored stool
4 Abdominal swelling

2
Iron supplements such as ferrous gluconate reduce peristalsis and result in constipation. Ferrous gluconate does not reduce blood pressure and does not result in hypotension. Ferrous gluconate can cause gastrointestinal bleeding and black, tarry stools. Ferrous gluconate does not cause fluid accumulation in the peritoneal cavity or abdominal swelling.

A patient that is receiving treatment for thalassemia show evidence of hemolysis. The nurse anticipates a prescription for which supplementation?

1 Zinc
2 Folic acid
3 Vitamin B 12
4 Ascorbic acid

2
Folic acid is given if there is any evidence of hemolysis in patients with thalassemia. Zinc supplementation is required in patients with thalassemia after chelation therapy, because zinc levels may decline. Vitamin B12 supplementation is required for patients with megaloblastic anemias. Ascorbic acid supplementation may be needed during chelation therapy in patients receiving treatment for thalassemia, because it increases urinary excretion of iron.

The nurse creates patient teaching information related to heparin therapy. The nurse recalls that heparin should never be given to a patient with a history of what?

1 Splenomegaly
2 Thromboembolism
3 Hepatic encephalopathy
4 Heparin-induced thrombocytopenia (HIT)

4
With HIT, heparin causes decreased platelet counts and increases the risk for hemorrhage. Patients who have had HIT should never be given heparin or low-molecular heparin (LMWH). This should be clearly marked in the patient's medical record. Splenomegaly is an enlarged spleen; this often occurs with anemia and autoimmune disorders. Hepatic encephalopathy occurs in alcoholic clients when brain tissue is destroyed due to decreased thiamine. Thromboembolism is another term for blood clot; heparin is used to treat clots and would not cause them.

The nurse reviews the history of an older patient and notes increased fatigue, headache, pale skin, and glossitis. The nurse suspects the patient has microcytic, hypochromic anemia and should provide what teaching?

1 Take enteric-coated iron with each meal.
2 Take cobalamin with green leafy vegetables.
3 Take the iron with orange juice one hour before meals.
4 Decrease the intake of the antiseizure medications to improve.

4
With microcytic, hypochromic anemia, there may be an iron, B6, or copper deficiency, thalassemia, or lead poisoning. The iron prescribed should be taken with orange juice one hour before meals as it is absorbed best in an acid environment. Megaloblastic anemias occur with cobalamin (vitamin B12) and folic acid deficiencies. Vitamin B12 may help red blood cell (RBC) maturation if the patient has the intrinsic factor in the stomach. Green leafy vegetables provide folic acid for RBC maturation. Antiseizure drugs may contribute to aplastic anemia or folic acid deficiency, but the patient should not stop taking the medications. Changes in medications will be prescribed by the health care provider.

A patient experiences anemia secondary to acute blood loss following trauma. The patient asks the nurse about treatment that will be needed following discharge. How should the nurse respond?

1 "You will need to take an iron supplement for the rest of your life to make sure the anemia does not return."
2 "You will need to make dietary changes to help support the production of red blood cells for the next one to two years."
3 "It would be best to take several supplements to prevent the anemia from recurring, including folic acid, niacin, and riboflavin."
4 "Once the blood loss is controlled and blood volume is replaced, the anemia generally corrects itself, so no long-term treatment is needed.

4
Anemia caused by acute blood loss generally resolves itself once the source of the bleeding is identified and controlled and blood/fluid volume is replaced. It is incorrect to tell the patient he or she will need supplements for the rest of his or her life, that several supplements are necessary to prevent recurrence, or that dietary changes will be necessary for the next year or two

A patient is diagnosed with coagulopathy and receives a prescription for warfarin therapy. The nurse provides dietary education. Which statement made by the patient indicates that the teaching was effective?

1 "Vitamin K is only in fruits and salad."
2 "I can eat as many green, leafy vegetables as I want."
3 "I need to have a consistent amount of vitamin K in my diet."
4 "I should avoid green, leafy vegetables, and I cannot eat salad regularly."

3
Patients on warfarin therapy must be taught to identify foods high in vitamin K and to consume consistent amounts daily. Patients should be advised not to eat large amounts of green, leafy vegetables sporadically as this decreases the effectiveness of warfarin. A balanced diet that includes a consistent amount of vitamin K is necessary to maintain good health. As such, patients should not avoid foods containing vitamin K. Vitamin K is found in many fruits, vegetables, and meats.

Which instruction is beneficial for the nurse to provide to a patient diagnosed with pernicious anemia?

1 "Avoid consuming red meat and fish."
2 "Limit consuming milk and dairy products."
3 "Undergo frequent hepatitis C screenings."
4 "Undergo frequent gastrointestinal cancer screenings."

4

Pernicious anemia is characterized by decreased secretion of hydrochloric acid in the stomach due to autoimmune-mediated destruction of parietal cells and thereby causes an increased risk for gastric cancer. The patient with cobalamin deficiency can develop pernicious anemia, so the patient should consume foods such as red meat, fish, milk and dairy products. Patients with thalassemia may contract hepatitis C from blood transfusions.

When teaching a patient about treatment for iron deficiency, the nurse provides a list of foods that provide nutritional support for hemoglobin synthesis. Which foods should the nurse include on the list? Select all that apply.

1 Legumes
2 Dried fruits
3 Strawberries
4 Milk products

1, 2, 5
Legumes, dried fruits, and dark green leafy vegetables contain iron, which supports hemoglobin synthesis. Strawberries provide vitamin C, which converts folic to its active forms and aids iron absorption but not hemoglobin synthesis. Milk products contain riboflavin and amino acids but do not support hemoglobin synthesis.

A patient is prescribed oral iron for the treatment of anemia. The nurse should instruct the patient about what side effects? Select all that apply.

1 Anorexia
2 Red stools
3 Heartburn
4 Black stools
5 Constipation

3, 4, 5
Because the GI tract excretes excess iron, the primary side effects of oral iron preparations are heartburn, black stools, and constipation. Red stool is not a side effect of iron preparation, but can be caused by the presence of fresh blood in the stools due to bleeding from hemorrhoids or irritable bowel syndrome. Anorexia is not an expected side effect.

The nurse provides dietary teaching to a patient with anemia and should include which food sources to promote red blood cell (RBC) maturation? Select all that apply.

1 Shellfish
2 Bananas
3 Avocados
4 Red meat
5 Cornmeal

3, 4
Avocado contains niacin, which is required for the maturation of RBC. Red meat is rich in cobalamin (Vitamin B12). Cobalamin is an essential nutrient that plays an important role in erythropoiesis by enhancing the RBC maturation. Therefore, the nurse would expect these two food sources to promote red blood cell (RBC) maturation. Shellfish contains copper, which is an essential nutrient useful for mobilization of iron from tissues to plasma. Bananas and cornmeal are rich in pyridoxine (Vitamin B6), which is essential for hemoglobin synthesis.

The nurse recalls that hemolytic anemia can be caused by which extrinsic factors?

1 Infectious agent
2 Enzyme deficiency
3 Sickle cell disease
4 Membrane abnormalities

1
Infectious agents, such as malaria, are c extrinsic factors that can lead to acquired hemolytic anemias. Membrane abnormalities, such as paroxysmal nocturnal hemoglobinuria, cause increased RBC destruction and are hereditary (intrinsic) factors, Abnormal hemoglobin, such as sickle cell disease, and enzyme deficiencies are intrinsic factors that lead to hereditary (intrinsic) hemolytic anemias.

A nurse mentor provides teaching to a group of nursing students about the cardiac manifestations of severe anemia. Which compensatory cardiac changes should the nurse include? Select all that apply.

1 Tachycardia
2 Heart failure
3 Diastolic murmurs
4 Intermittent claudication
5 Decreased pulse pressure

1, 2, 4
The compensatory cardiac symptoms of severe anemia are tachycardia, heart failure, and intermittent claudication. The cardiac murmurs that occur in severe anemia are systolic, not diastolic, in nature. In severe anemia, there is an increase in pulse pressure.

The nurse assesses a patient who has severe anemia and expects to find which manifestations? Select all that apply.

1 Vertigo
2 Dyspnea at rest
3 Sensitivity to heat
4 Jaundice and pruritus
5 Glossitis and smooth tongue

1, 2, 4, 5
In severe anemia (Hgb less than 6 g/dL [60 g/L]), the patient has many clinical manifestations involving multiple body systems, including jaundice, pruritus, glossitis, smooth tongue, vertigo, dyspnea at rest, and sensitivity to cold. The patient will not have sensitivity to heat.

The nurse is caring for a patient with severe anemia and expects which compensatory respiratory changes? Select all that apply.

1 Orthopnea
2 Tachypnea
3 Dyspnea at rest
4 Dyspnea on exertion
5 Impaired thought process

1, 2 ,3
The compensatory respiratory changes that occur in severe anemia are tachypnea, orthopnea, and dyspnea at rest. Impaired thought process is a neurologic symptom associated with anemia. Dyspnea on exertion is seen in mild anemia.

The nurse provides discharge teaching to a patient with chronic anemia. What should the nurse include in the education?

1 Take vitamin C
2 Avoid large crowds
3 Participate in a nutrition education session
4 Anticipate the need for supplemental iron injections

3
The cause of chronic anemia is often inadequate dietary intake of foods high in iron. In most cases of iron-deficiency anemia, the condition may be prevented by consuming a nutritionally balanced diet. Attending a nutrition education session will increase compliance with the recommended diet. Taking supplements of vitamin C, which will increase iron absorption from the GI tract, avoiding large crowds, and discussing the possibility of long-term supplemental iron injections will not have a direct effect on post-discharge management of anemia.

The nurse cares for a patient with iron-deficiency anemia. Which nursing diagnostic statement associated with the condition is the highest priority?

1 Deficient fluid volume
2 Impaired gas exchange
3 Impaired breathing pattern
4 Decreased cardiac output

2
Iron is necessary for hemoglobin synthesis. Hemoglobin is responsible for oxygen transport in the body. With iron-deficiency anemia a subnormal hemoglobin level cannot carry enough oxygen to the tissues. This results in impaired tissue oxygenation caused by impaired gas exchange. Deficient fluid volume and decreased cardiac output are not directly associated with iron-deficiency anemia. An impaired breathing pattern may develop as a result of impaired gas exchange.

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Which foods will the nurse recommend to a client with iron deficiency anemia?

What foods treat iron deficiency anemia?

Which food should the nurse recommend for a child with iron deficiency anemia?

What type of food will you advice to her in order to treat her anemia?