An adolescent girl reports having heavy menstrual periods. Her ...

[CharlieWard]

An adolescent girl reports having heavy menstrual periods. Her hemoglobin is consistently on the low end of the normal range. The primary care NP should prescribe:
 
  a. iron supplements.
  b. a folic acid supplement.
  c. oral contraceptive pills.
  d. increased red meats in her diet.

Question 2

The parent of a 3-year-old is concerned that the child's legs are not straight. The primary care NP notes marked bowing of the child's lower extremities. Radiologic studies show decreased ossification of the child's bones. The NP should:
 
  a. prescribe vitamin D supplements.
  b. recommend calcium supplements.
  c. counsel the parent to increase the child's milk intake.
  d. ensure that the parent is buying vitamin Dfortified milk.

[vish98]

Answer to Question 1

C
Women are at risk for iron-deficiency anemia from menstrual blood loss. Taking oral contraceptives reduces this risk by moderating periods. Iron would be indicated if anemia actually occurs, but this patient is just at risk. Folic acid supplements are not indicated to prevent iron-deficiency anemia. Dietary iron usually is not sufficient for replacing iron losses.

Answer to Question 2

A
Children who do not get enough vitamin D can have abnormalities in bone ossification leading to rickets, which is characterized by bowing of the legs. The NP should prescribe vitamin D. Calcium supplements or increased milk intake would not be helpful. Without vitamin D, the body cannot use calcium for bone ossification. The amount of vitamin D in fortified milk is not sufficient to overcome vitamin D deficiency.

[CharlieWard]

TYSM

[Alyson.hiatt@yahoo.com]

Thanks for the timely response, appreciate it