A nurse is reinforcing teaching about foods that are high in folic acid with a client who is at 8 weeks of gestation. Which of the following foods should the nurse recommend as the best source of folic acid?

Rationale:

A. "Your child should have surgery in 7 to 10 days to remove the tumor.": Surgical removal of the tumor is a priority and is usually scheduled promptly after diagnosis, not delayed by a week or more. Early intervention reduces the risk of tumor rupture or metastasis.

B. "You should not palpate your child's abdomen prior to surgery.": Avoiding abdominal palpation is crucial because Wilms’ tumors are highly vascular and encapsulated. Palpation could cause rupture, leading to tumor cell spread into the peritoneal cavity and increasing the risk of metastasis.

C. "You should give your child captopril 200 mg PO daily.": Captopril is not a standard medication in the treatment of Wilms’ tumor. It is an antihypertensive that may be used if the child has associated hypertension, but the dosage listed is excessive for pediatric use and should not be prescribed without specific indications.

D. "Your child will not require further treatment after removal of the tumor.": Most children require additional therapy, such as chemotherapy and/or radiation, depending on tumor staging. Surgical removal alone is rarely curative, particularly in advanced or bilateral cases.

Rationale:

A. "Colostrum provides vitamin K which is an essential nutrient for newborns." While vitamin K is essential for clotting, it is not found in sufficient amounts in colostrum. This is why newborns routinely receive a vitamin K injection shortly after birth, rather than relying on breast milk as a source.

B. "Colostrum provides many important antibodies that the newborn lacks." Colostrum is rich in immunoglobulins, especially IgA, which help protect the newborn from pathogens by providing passive immunity. These antibodies line the infant's gastrointestinal tract and offer critical defense during early life.

C. "Colostrum contains iron, which is important for a newborn's brain development." Although breast milk contains iron, colostrum is not a major source of it. Newborns are typically born with adequate iron stores to last several months, and the primary role of colostrum is immune protection, not iron supplementation.

D. "Colostrum contains a natural diuretic that stimulates the newborn to void." While colostrum has a laxative effect that helps the newborn pass meconium, there is no known diuretic component. Its primary importance lies in delivering antibodies and coating the GI tract to reduce infection risk.