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 A
Explanation
The correct answer is choice A: “The discharge that you are describing is normal at this time.” This is because the client is experiencing lochia serosa, which is a brownish discharge that occurs from about day 4 to day 10 postpartum.
Lochia serosa is composed of old blood, serum, leukocytes, and tissue debris.
It indicates that the placental site is healing and the uterus is involuting.
Choice B is wrong because fever is a sign of infection, not normal lochia.
Choice C is wrong because ovulation usually does not resume until 6 weeks postpartum for nonbreastfeeding women and later for breastfeeding women.
Choice D is wrong because iron supplements do not affect lochia color or amount.
Correct Answer is B
Explanation
The correct answer is choice B. Taking mineral oil each night is not recommended for pregnant women who have hemorrhoids because it can interfere with the absorption of fat-soluble vitamins and cause diarrhea, which can worsen hemorrhoids.
The patient should avoid laxatives and stool softeners unless prescribed by a health care provider.
Choice A is wrong because walking at least a mile a day can help improve blood circulation and prevent constipation, which are both beneficial for hemorrhoid management.
Choice C is wrong because including foods high in fiber in the diet can help soften stools and prevent straining, which can aggravate hemorrhoids.
Choice D is wrong because drinking one extra glass of water before breakfast each morning can help hydrate the body and prevent dehydration, which can cause hard stools and increase pressure on the anal veins.
The nurse should teach the patient other strategies for hemorrhoid management, such as applying ice packs or witch hazel pads to the affected area, using sitz baths or warm water baths, avoiding prolonged sitting or standing, and wearing cotton underwear.
The nurse should also advise the patient to report any signs of infection or bleeding to the health care provider.
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