A nurse is caring for an antepartum client who has iron deficiency anemia. When teaching the client about nutrition, the nurse should emphasize the need for an increased intake of which of the following foods?
Fresh fruits
Milk and cheese
Whole grain breads
Red meat and organ meats
The Correct Answer is D
Choice A reason: Fresh fruits are incorrect because they are not rich sources of iron. They are good sources of vitamin C, which can enhance iron absorption, but they do not provide enough iron by themselves.
Choice B reason: Milk and cheese are incorrect because they are not rich sources of iron. They are good sources of calcium, which is important for bone health, but they can interfere with iron absorption if consumed in excess.
Choice C reason: Whole grain breads are incorrect because they are not rich sources of iron. They are good sources of complex carbohydrates, which provide energy and fiber, but they contain phytates, which can inhibit iron absorption.
Choice D reason: Red meat and organ meats are correct because they are rich sources of iron. They contain heme iron, which is more easily absorbed by the body than non-heme iron from plant sources. They also provide protein, which is essential for tissue growth and repair.
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Correct Answer is B
Explanation
Choice A reason: This is incorrect. Decreased production of erythrocytes (red blood cells) is a consequence, not a cause, of iron deficiency anemia. Iron is needed to make hemoglobin, the protein that carries oxygen in the red blood cells. Without enough iron, the body cannot produce enough hemoglobin or red blood cells¹.
Choice B reason: This is correct. Inadequate intake of iron is the most common cause of iron deficiency anemia during pregnancy. Pregnant women need more iron than nonpregnant women to support the increased blood volume and the fetal growth. If the dietary intake of iron is not sufficient, the body will use up its iron stores, leading to iron deficiency anemia.
Choice C reason: This is incorrect. Dilution of hemoglobin concentration is a normal physiological change during pregnancy, not a cause of iron deficiency anemia. The blood volume increases by 20% to 30% during pregnancy, while the red blood cell mass increases by only 15% to 20%. This results in a lower concentration of hemoglobin in the blood, but not necessarily a lower amount of hemoglobin or iron³.
Choice D reason: This is incorrect. The fetus establishing iron stores is not a cause of iron deficiency anemia during pregnancy, although it can contribute to it. The fetus needs iron for its own development and growth, and it obtains iron from the mother through the placenta. The fetal iron demand increases in the second and third trimesters, when the fetus accumulates iron in its liver and other tissues. This can deplete the maternal iron stores, especially if the mother does not consume enough iron.
Correct Answer is D
Explanation
Choice A reason: Congenital anomalies of the central nervous system are not a common complication of GDM, as they usually occur in the first trimester, before GDM develops. However, GDM can increase the risk of other congenital anomalies, such as cardiac defects or neural tube defects.
Choice B reason: Preterm birth is a possible complication of GDM, as it can be caused by maternal hypertension, preeclampsia, or placental abruption. However, it is not the most likely complication, as GDM can also delay the onset of labor and prolong the pregnancy.
Choice C reason: Low birth weight is not a typical complication of GDM, as it is more associated with intrauterine growth restriction (IUGR), which is caused by placental insufficiency. GDM can cause the opposite problem, which is excessive fetal growth.
Choice D reason: Macrosomia is the most common complication of GDM, as it is defined as a birth weight of more than 4,000 grams (8.8 pounds). It is caused by the excess glucose crossing the placenta and stimulating the fetal insulin production, which leads to increased fat deposition and organ enlargement. Macrosomia can increase the risk of birth trauma, shoulder dystocia, and neonatal hypoglycemia.
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