The patient at 20 weeks' gestation has had an ultrasound that revealed a neural tube defect in her fetus. The patient's hemoglobin level is 8.5. The nurse should include which statement when discussing these findings with the patient?

Question

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."

Answer 1

4
Rationale 1: Low hemoglobin does not cause neural tube defects.
Rationale 2: Vitamin C will increase iron absorption, but this patient is deficient in folic acid.
Rationale 3: Therapeutic communication requires that the nurse avoid judgmental statements.
Rationale 4: Folic acid deficiency can cause both neural tube defects and megaloblastic anemia, in which the red cells are immature and abnormally large.