A pregnant client arrives for her first prenatal visit at the clinic. She tells you that she has been taking an additional 400 mcg of folic acid prior to her pregnancy. Based on information obtained, she is at 8 weeks' gestation
What recommendation would you give regarding folic acid supplementation?
a. Have the client continue to take 400 mcg folic acid throughout her pregnancy.
b. Tell the client that she no longer has to take additional folic acid because it will be included in her prenatal vitamins.
c. Have the client increase her folic acid intake to 1000 mcg throughout the rest of her pregnancy.
d. Schedule the client to go for an AFP (alpha-fetoprotein) test.
ANS: B
Prenatal vitamins include adequate folic acid supplementation, so clients should not take additional supplementation as long they continue their prenatal vitamins. During pregnancy, the recommendation is to increase the folic acid intake to 600 mcg. 1000 mcg of folic acid would be an excessive dose. The AFP test should be done at 15 to 18 weeks' gestation. This is not clinically indicated because the client is at 8 weeks' gestation.
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