The client at 20 weeks' gestation has had an ultrasound that revealed that her fetus has a neural tube defect. The client's hemoglobin level is 8.5. The nurse should include which statement when discussing these findings with the client?
1. "Your low iron intake has caused anemia, which leads to the neural tube defect."
2. "You should increase your vitamin C intake to improve your anemia."
3. "You are too picky about food. Your poor diet caused your baby's defect."
4. "You haven't had enough folic acid in your diet. You should take a supplement."
4
Rationale:
1. Low hemoglobin does not cause neural tube defects.
2. Vitamin C will increase iron absorption, but this client is deficient in folic acid.
3. Therapeutic communication must avoid judgmental statements.
4. Folic acid deficiency can cause both neural tube defects and megaloblastic anemia, in which the red cells are immature and abnormally large.
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