A parent calls the nurse to report that a 5-year-old child has ...

[kshipps]

A parent calls the nurse to report that a 5-year-old child has taken five children's vitamins. Which action will the nurse take first?
 
  a. Ask whether the vitamins contain iron.
  b. Reassure the parent that over-the-counter vitamins are not toxic.
  c. Recommend that the parent take the child to the emergency department (ED).
  d. Tell the parent to watch for tarry stools and report them immediately.

Question 2

A female patient who has a history of heavy menstrual periods is experiencing shortness of breath with exertion, pallor, and fatigue.
 
  Her hemoglobin and hematocrit levels are both lower than normal, and her CBC reveals microcytic and hypochromic erythrocytes. What will the nurse do?
  a. Contact the provider to discuss an order for 600 mg of PO ferrous sulfate BID.
  b. Recommend an over-the-counter folic acid supplement of 400 mcg/day.
  c. Suggest an over-the-counter iron supplement of 325 mg/day.
  d. Tell her to consult a dietician about including iron-rich foods in her diet.

[Anton]

Answer to Question 1

ANS: A
Iron toxicity is a serious cause of poisoning in children, and as few as 10 to 12 tablets of ferrous sulfate can be fatal within 12 to 48 hours. The nurse should first determine whether the vitamins contain iron. If so, the family should take the child to the ED.

Answer to Question 2

ANS: A
This patient has positive findings for iron-deficiency anemia and will need therapeutic doses of iron, which is 600 to 1200 mg/day in divided doses. Her lab tests are not consistent with folic acid deficiency. Iron supplementation of 300 to 325 mg/day is correct for prophylactic supplementation. When deficiency is present, it is very difficult to obtain the necessary amount of iron from food sources alone.

[kshipps]

TYSM

[parshano]

Excellent