On her first visit, a patient had a baseline hemoglobin of 13.0 gm and a hematocrit of 42.9%.She has been taking ferrous sulfate tablets and eating an iron-rich diet.She returned to the clinic at 30 weeks gestation and has a hemoglobin of 11.0 gm and a hematocrit of 36.3%.She is concerned and confused about why these lab values have gone down.
In responding, which physiological change during pregnancy should the nurse describe to the patient?
The increase in the level of placental hormones tends to result in chelation of maternal iron.
Fetal demand for iron is greater than the maternal intake.
During the latter half of pregnancy, the maternal intestinal absorption of iron is decreased.
The increase in maternal blood volume is greater than the increase in maternal red blood cells.
The Correct Answer is D
The correct answer is choice D. The increase in maternal blood volume is greater than the increase in maternal red blood cells.
This means that the concentration of hemoglobin and hematocrit in the blood is diluted by the extra fluid.
This is a normal physiological adaptation to pregnancy and does not indicate iron deficiency anemia.
Choice A is wrong because placental hormones do not chelate maternal iron.
Chelation is a process of binding metal ions to organic molecules, which is not relevant to this question.
Choice B is wrong because fetal demand for iron is not greater than maternal intake.
The mother can meet the iron needs of the fetus by increasing her dietary intake and taking iron supplements.
Choice C is wrong because maternal intestinal absorption of iron is not decreased during pregnancy.
In fact, it may be increased due to higher levels of estrogen and progesterone.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
The correct answer is choice D. The fluid that the mother has in her breasts before the milk comes in is called colostrum, which is rich in antibodies and nutrients that the baby needs.
It also helps to prevent jaundice by stimulating the baby’s bowel movements.
Therefore, the nurse should encourage the mother to breastfeed as soon as possible after birth and explain the benefits of colostrum.
Choice A is wrong because it discourages breastfeeding and may interfere with milk production and bonding.
Choice B is wrong because it implies that breastfeeding is only a skill and not a natural process that benefits both the mother and the baby.
Choice C is wrong because it focuses on the emotional aspect of breastfeeding and not the physiological one.
While breastfeeding may enhance the closeness between the mother and the baby, it is not the only reason to breastfeed.
Correct Answer is D
Explanation
The correct answer is choice D. Gestational age of 35-38 weeks.
This is because preterm babies are more likely to develop jaundice due to their immature liver and increased breakdown of red blood cells.Babies born between 35 and 38 weeks are considered late preterm and have a higher risk of jaundice than full-term babies.
Choice A is wrong because African American ethnicity is not a risk factor for jaundice.In fact, Asian, European, or native American ethnicity are more associated with jaundice.
Choice B is wrong because meconium-stained amniotic fluid is not a risk factor for jaundice.
Meconium is the first stool of the baby and it may indicate fetal distress, but it does not affect the bilirubin level.
Choice C is wrong because bottle feeding is not a risk factor for jaundice.In fact, breastfeeding is more associated with jaundice due to dehydration and poor caloric intake.
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