Which client is most likely to require a folic acid supplement to ...

[bclement10]

Which client is most likely to require a folic acid supplement to treat anemia?
 
  1. A client who has a forearm arterial-venous shunt and is scheduled for dialysis three times weekly
  2. A client who has a history of chronic heart failure with multiple exacerbations
  3. A client who has a history of chronic heavy alcohol intake
  4. A client who has a history of type 2 diabetes mellitus

Question 2

Morphology reports on a blood smear from a client who has documented anemia show normocytic-normochromic red blood cells. Which assessment questions should the nurse ask to further identify the etiology of this anemia?
 
  Standard Text: Select all that apply.
  1. Do you eat enough foods that contain iron?
  2. Have you experienced any episodes of bleeding?
  3. Do you follow a strict vegetarian diet?
  4. Do you get enough folate in your diet?
  5. Do you work around any strong chemicals?

[CourtneyCNorton]

Answer to Question 1

Correct Answer: 3
Rationale 1: Folic acid is not primary therapy in the management of kidney-failure anemia, which responds better to epoetin alfa.
Rationale 2: Folic acid is not useful in the management of chronic heart failure. However, folic acid might be ordered for another reason related to its effects on long-term vascular health.
Rationale 3: Folic acidrelated anemia is usually associated with poor nutrition. Ethanol interferes with folate metabolism in the liver, and the alcoholic's diet is often low in the nutrient.
Rationale 4: Folic acid is not useful in the management of type 2 diabetes.
Global Rationale: Folic acidrelated anemia is usually associated with poor nutrition. Ethanol interferes with folate metabolism in the liver, and the alcoholic's diet is often low in the nutrient. Folic acid is not primary therapy in the management of kidney-failure anemia, which responds better to epoetin alfa. Folic acid is not useful in the management of chronic heart failure. However, folic acid might be ordered for another reason related to its effects on long-term vascular health. Folic acid is not useful in the management of type 2 diabetes.

Answer to Question 2

Correct Answer: 2,5
Rationale 1: Iron deficiency anemia results in microcytic-hypochromic red blood cells.
Rationale 2: Hemorrhagic anemia results in normocytic-normochromic red blood cells.
Rationale 3: Pernicious anemia can result from inadequate B12 intake, which can occur in a client on a strict vegetarian diet. Pernicious anemia results in macrocytic-normochromic red blood cells.
Rationale 4: Folate deficiency results in macrocytic-normochromic red blood cells.
Rationale 5: Exposure to some chemicals can result in hemolytic anemia. Hemolytic anemia results in normocytic-normochromic red blood cells.
Global Rationale: Hemorrhagic anemia results in normocytic-normochromic red blood cells. Exposure to some chemicals can result in hemolytic anemia. Hemolytic anemia results in normocytic-normochromic red blood cells. Iron deficiency anemia results in microcytic-hypochromic red blood cells. Pernicious anemia can result from inadequate B12 intake, which can occur in a client on a strict vegetarian diet. Pernicious anemia results in macrocytic-normochromic red blood cells. Folate deficiency results in macrocytic-normochromic red blood cells.

[bclement10]

Excellent

[bigcheese9]

TYSM