A pregnant client arrives for her first prenatal visit at the ...

[ETearle]

A pregnant client arrives for her first prenatal visit at the clinic. She tells you that she has been taking an additional 400 mcg of folic acid prior to her pregnancy. Based on information obtained, she is at 8 weeks' gestation.
 
  What recommendation would you give regarding folic acid supplementation?
 
  a. Have the client continue to take 400 mcg folic acid throughout her pregnancy.
  b. Tell the client that she no longer has to take additional folic acid because it will be included in her prenatal vitamins.
  c. Have the client increase her folic acid intake to 1000 mcg throughout the rest of her pregnancy.
  d. Schedule the client to go for an AFP (alpha-fetoprotein) test.

Question 2

Which food selections would lead to enhanced iron absorption during pregnancy?
 
  a. Eating additional fiber and grains in the diet
  b. Drinking coffee with meals
  c. Drinking orange juice
  d. Including spinach in the diet two to three times a week

[al]

Answer to Question 1

ANS: B
Prenatal vitamins include adequate folic acid supplementation, so clients should not take additional supplementation as long they continue their prenatal vitamins. During pregnancy, the recommendation is to increase the folic acid intake to 600 mcg. 1000 mcg of folic acid would be an excessive dose. The AFP test should be done at 15 to 18 weeks' gestation. This is not clinically indicated because the client is at 8 weeks' gestation.

Answer to Question 2

ANS: C
Drinking orange juice, which contains ascorbic acid, acts to enhance iron absorption. Foods that are high in fiber and grains contain phytates, which can decrease iron absorption. Coffee intake can affect iron binding and therefore decrease absorption. Spinach contains oxalates, which can interfere with iron absorption.