A pregnant patient with pallor and fatigue has Hgb 9 g/dL. What is the priority nursing action?

A pregnant patient with pallor and fatigue has Hgb 9 g/dL. What is the priority nursing action?

• A. Assess for iron-deficiency anemia and start iron supplementation with education on iron-rich foods and vitamin C to enhance absorption and reduce constipation.
• B. Schedule a transfusion immediately.
• C. Reassure the patient that anemia is common and requires no action.
• D. Advise reducing iron intake to prevent constipation.

Answer: (A)

The key idea being tested is recognizing iron-deficiency anemia in pregnancy and making the treatment plan a priority to improve oxygen delivery for both mother and fetus. A pregnant patient with pallor and fatigue and a hemoglobin of 9 g/dL likely has iron-deficiency anemia, so starting iron therapy is essential. Begin oral iron and simultaneously provide education on iron-rich foods and the role of vitamin C to enhance absorption. Explaining that iron supplements can cause constipation helps you address a common side effect and keep the patient adherent. This approach targets rising Hb levels and correcting iron stores, which is safer and more appropriate than rushing to a transfusion or doing nothing. Transfusion isn’t the immediate priority unless there are signs of hemodynamic instability or ongoing significant blood loss. Reassurance alone is not appropriate because this condition requires treatment to prevent maternal and fetal complications. Reducing iron intake would worsen the problem, not help it.

The key idea being tested is recognizing iron-deficiency anemia in pregnancy and making the treatment plan a priority to improve oxygen delivery for both mother and fetus. A pregnant patient with pallor and fatigue and a hemoglobin of 9 g/dL likely has iron-deficiency anemia, so starting iron therapy is essential. Begin oral iron and simultaneously provide education on iron-rich foods and the role of vitamin C to enhance absorption. Explaining that iron supplements can cause constipation helps you address a common side effect and keep the patient adherent. This approach targets rising Hb levels and correcting iron stores, which is safer and more appropriate than rushing to a transfusion or doing nothing.

Transfusion isn’t the immediate priority unless there are signs of hemodynamic instability or ongoing significant blood loss. Reassurance alone is not appropriate because this condition requires treatment to prevent maternal and fetal complications. Reducing iron intake would worsen the problem, not help it.