A nurse is caring for a female client in a provider’s office.
Nurses’ Notes
Laboratory Results
Provider Prescriptions
0900:
The client is being seen in the office. The client reports feeling fatigued and having a heavy menstrual cycle the past year. Upon assessment, the client’s conjunctiva and mucosal membranes are pale. Provider notified and laboratory samples to be drawn. 2 Days Later:
Provider reviewed laboratory results and prescription written.
The nurse notifies the client and provides teaching about the newly prescribed medication. For each of the statements made by the client, click to specify whether the statement indicates an understanding or no understanding of the teaching provided.
Client Education: Understanding/ No Understanding
Understanding No Understanding
“I should take my medication on an empty stomach.”
“I should avoid taking antacids while on this medication,”
“If I experience black stools, I should notify my provider.”
“I should rinse my mouth after taking this medication.”
“I should take this medication with orange juice”
The Correct Answer and Explanation is:
The client is being prescribed a medication to address symptoms of fatigue and heavy menstrual bleeding, which are indicative of possible iron deficiency anemia. Given the context and common practices in treating iron deficiency anemia, the prescribed medication is likely an oral iron supplement. Let’s evaluate the client’s understanding based on the typical instructions for iron supplements:
- “I should take my medication on an empty stomach.”
- Understanding: Iron supplements are best absorbed when taken on an empty stomach. Food, particularly dairy products and certain high-fiber foods, can interfere with iron absorption. The client’s understanding of this instruction is correct.
- “I should avoid taking antacids while on this medication.”
- Understanding: Antacids can reduce the absorption of iron supplements. Since iron absorption is sensitive to changes in stomach pH, taking antacids can interfere with how well the iron is absorbed. The client’s understanding is correct.
- “If I experience black stools, I should notify my provider.”
- Understanding: Iron supplements often cause black or dark green stools, which is a common and benign side effect. However, if the client is unsure or concerned about the cause of the black stools, they should consult their provider to rule out other potential issues, such as gastrointestinal bleeding. Advising the client to notify their provider ensures they are vigilant about their health. The client’s understanding is correct.
- “I should rinse my mouth after taking this medication.”
- No Understanding: Oral iron supplements can sometimes cause staining of the teeth. Rinsing the mouth after taking the supplement can help mitigate this issue and improve oral hygiene. If the client did not receive this specific instruction, it indicates a lack of understanding about this precaution.
- “I should take this medication with orange juice.”
- Understanding: Vitamin C enhances the absorption of iron from supplements. Taking iron supplements with a source of vitamin C, like orange juice, is often recommended to improve absorption. The client’s understanding is correct.
Explanation
Iron supplements are commonly prescribed for iron deficiency anemia, which can cause fatigue and pallor. These supplements are best taken on an empty stomach to maximize absorption. However, because iron supplements can interact with certain medications, such as antacids, clients are advised to avoid taking them together. Black stools are a typical side effect of iron supplementation, and clients should be informed about this to prevent unnecessary concern or misinterpretation of symptoms. Oral iron supplements can also stain teeth, so rinsing the mouth after taking the medication can help prevent this. Additionally, vitamin C enhances iron absorption, so taking iron supplements with a source of vitamin C, like orange juice, is a common recommendation. Each of these instructions helps ensure the effective and safe use of iron supplements.