A woman at 30 weeks' gestation and a history of sickle cell ...

[LCritchfi]

A woman at 30 weeks' gestation and a history of sickle cell anemia is experiencing fever, chills, and diarrhea for 3 days. What are the most serious potential complications that this client faces?
 
  1. Severe lethargy
  2. Sickle cell crisis
  3. Electrolyte imbalance
  4. Fetal neural tube defects

Question 2

A pregnant client at 23 weeks' gestation has a hemoglobin of 9.5. Which diet choice indicates that teaching has been effective?
 
  1. Broiled fish, lettuce salad, grapefruit half, carrot sticks
  2. Pork chop, mashed potatoes and gravy, cauliflower, tea
  3. Roast beef, steamed spinach, tomato soup, orange juice
  4. Tofu with mixed vegetables in curry, milk, whole-wheat bun

[Chocorrol77]

Answer to Question 1

2
Explanation:
1. While the client may develop severe lethargy, her greatest risk concerns development of sickle cell crisis.
2. Dehydration and fever can trigger sickling and crisis; for this reason, maternal infections are treated promptly.
3. While the client may experience electrolyte imbalance, sickle cell crisis is the most serious potential complication of dehydration and fever.
4. Fever, chills, and dehydration in the client with sickle cell anemia are not associated with an increased incidence of neural tube defects.

Answer to Question 2

3
Explanation:
1. This meal is high in fiber, low in fat, and moderately high in protein, but low in iron. This client is anemic and needs iron.
2. This meal has a moderate amount of protein, but no vitamin C. The meal containing beef is better.
3. This client is anemic and needs iron. This meal contains iron in the beef, folic acid in the spinach, and vitamin C in the tomato soup and orange juice. Vitamin C helps absorption of the iron; folic acid is needed for production of red cells.
4. This diet is high in calcium. The client has iron-deficiency anemia and requires a high-iron diet.