A nurse is providing prenatal teaching about iron to a client who follows a vegetarian diet. The nurse should recommend that the client consume which of the following foods to enhance the absorption of nonheme iron?

Rationale:

A. Buy disposable dishes for daily use: HIV is not transmitted through saliva or casual household contact, including sharing dishes. Disposable dishes are unnecessary and promote stigma.

B. Clean blood-contaminated surfaces with bleach: A 1:10 bleach solution is effective in killing HIV on surfaces. Proper cleaning of blood spills is essential for preventing transmission.

C. Wash soiled clothes in cold water: Hot water (not cold) and detergent should be used to clean potentially contaminated clothing to reduce the risk of infection.

D. Use condoms with a petroleum-based lubricant: Petroleum-based lubricants degrade latex condoms, increasing the risk of breakage. Water- or silicone-based lubricants should be used instead.

Rationale for correct choices:

• Preeclampsia: The client presents with classic signs of preeclampsia, including elevated blood pressure (156/96 mm Hg), facial and dependent edema, hyperreflexia (DTR 3+), and right upper quadrant pain. Laboratory findings such as thrombocytopenia, elevated liver enzymes, and proteinuria also support this diagnosis.
• Urinalysis: Proteinuria is a key diagnostic criterion for preeclampsia, and this client’s urinalysis reveals protein levels (25 mg/dL) above normal limits, indicating kidney involvement and supporting the preeclampsia diagnosis.
• Pain assessment: Right upper quadrant pain is a significant symptom of preeclampsia, suggesting hepatic involvement such as liver capsule distension or possible HELLP syndrome. This pain, combined with other clinical and lab findings, signals severity and risk for maternal complications.

Rationale for incorrect choices:

• Chorioamnionitis: This infection is typically accompanied by fever, uterine tenderness, and foul-smelling discharge. The client is afebrile with clear lungs and no uterine tenderness, making chorioamnionitis unlikely.
• Preterm labor: No contractions or cervical changes were noted. The fetal heart rate is normal, and the client’s symptoms do not suggest imminent labor.
• Serum WBC count: The client’s WBC count is within normal limits, which does not support infection or inflammatory processes related to chorioamnionitis.
• Fundal assessment: Fundal height of 29 cm at 30 weeks is appropriate and shows no evidence of uterine enlargement or contraction indicative of preterm labor.
• Fetal monitor results: The fetal heart rate is 140/min and stable, showing no signs of distress that would suggest preterm labor or infection.
• Hemoglobin: Hemoglobin is within normal limits and does not contribute to the risk assessment for preeclampsia or infection.