The nurse is caring for a young female patient whose laboratory values indicate the presence of microcytic and hypochromic red blood cells. What should the nurse do to help this patient?
1. Enforce "nothing by mouth" in anticipation of emergency surgery.
2. Insert an intravenous access line for fluids.
3. Consult with the dietitian for a diet high in iron.
4. Assess the past history for risks of bleeding or menstrual changes.
Correct Answer: 4
The nurse should do additional health history assessment to identify the source of chronic bleeding. Questions related to length and amount of menstrual flow, color of stools, and any upper gastric bleeding/conditions that might be contributing to the potential bleeding should be asked before any other actions are taken. Emergency surgery is not the first action, as microcytic and hypochromic RBCs reflect a chronic bleeding condition, not an acute one. Fluid replacement would not address the blood cells' reduced ability to carry oxygen.
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