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Unfolding Case Study

1.
a. The recommended dose is 3–6 mg/kg/day for 2–3 months; 3 mg/kg/dose twice daily is equal to 6 mg/kg/day. Dividing the total daily dose will decrease gastrointestinal side effects.
2.
a. Having the client identify their food likes and dislikes is a collaborative strategy the nurse can use to develop a diet plan. Adolescents are more likely to adhere to diet modifications if they are partners in developing their nutritional plan.
3.
d. Taking iron with orange juice will increase gastrointestinal absorption. Taking iron with milk, tea, or coffee can decrease its absorption. Antacids should be taken 2 hours before or 4 hours after taking iron for better absorption because iron is better absorbed in an acidic environment. Missed doses of iron should not be made up.
4.
c. Feeling weak and dizzy may be a sign of low hemoglobin or worsening anemia. This can occur if oral iron is not absorbed sufficiently by the body.

Review Questions

1.
b. Common nutritional deficiencies affecting all ages include iron; vitamins B12, D, and K; and folate.
2.
a. The groups most frequently affected by anemia are pregnant individuals, infants and toddlers, female adolescents, and older adults.
3.
b. Infants and children have increased nutrient demands due to rapid physical and cognitive growth, resulting in rapid cell turnover.
4.
b. Decreased sun exposure is one of several risk factors for vitamin D deficiency.
5.
b. Zinc deficiency occurs in 31% of children between ages 1 and 3 years and can cause decreased immunity and increased infections. Foods rich in zinc include eggs and dairy products, which the child is not consuming.
6.
c. Clients with sickle cell disease are at high risk for vitamin D deficiency, which can increase their risk of disease-related effects.
7.
c. Older adults who consume excessive amounts of alcohol, live alone, smoke, or are obese are at risk for folate deficiency.
8.
b. Sickle cell disease is the most common inherited blood disorder in the United States. Clients with this disease are prone to micronutrient and macronutrient deficiencies.
9.
d. Iron-fortified foods such as breakfast cereals should be limited because this client is at risk for iron overload after the transfusion.
10.
c. The Mediterranean diet includes various foods and spices with anti-inflammatory and antioxidant properties.
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