Question

A client with iron-deficiency anemia is taking an oral iron supplement. The nurse should tell the client to take the medication with: A. Orange juice B. Water only C. Milk D. Apple juice

Short answer

Answer: The best choice of liquid for a client with iron-deficiency anemia to take with their oral iron supplement is orange juice, as it contains Vitamin C which has been shown to increase the absorption of iron, especially non-heme iron found in supplements.

Step-by-step solution

Understanding iron absorption

Iron is an essential mineral needed by the body for various functions including the production of red blood cells. Iron absorption can be affected by different factors such as the type of iron, presence of other substances in the diet or drinks consumed with it.

Evaluate the options

A. Orange juice - Orange juice is a good source of Vitamin C (ascorbic acid), which has been shown to increase the absorption of iron, especially non-heme iron found in plant-based foods and supplements. Therefore, taking the iron supplement with orange juice may enhance its absorption. B. Water only - While water does not have any negative impact on iron absorption, it does not contain any additional components that would enhance iron absorption either. C. Milk - Milk and other dairy products contain calcium, which may inhibit iron absorption. Thus, taking the iron supplement with milk might not be the best choice. D. Apple juice - Apple juice has a low Vitamin C content compared to orange juice. It does not provide the same level of enhancement in iron absorption.

Select the best option

Based on the analysis of each option, it is clear that taking the iron supplement with orange juice (Option A) would be the most beneficial choice, as it can potentially enhance iron absorption due to the presence of Vitamin C. Give to the client the advice to take the iron supplement with orange juice.

Key concepts

Oral Iron Supplements

Oral iron supplements are a common and effective treatment for iron-deficiency anemia, a condition characterized by a reduced number of red blood cells due to a lack of iron. This mineral is crucial for producing hemoglobin, a protein in red blood cells that carries oxygen throughout the body.

When prescribing oral iron supplements, it is important to understand the various forms available. Iron supplements come in two forms: heme iron, which is derived from hemoglobin and found in animal products, and non-heme iron, which is found in plants and iron-fortified foods. Non-heme iron is more common in supplements and is not absorbed as efficiently as heme iron.

Oral iron supplements should be taken on an empty stomach to maximize absorption. However, since they can cause gastrointestinal upset, some individuals might need to take them with a small amount of food. It’s also important to avoid taking iron with antacids, caffeine, and some medications, as these can interfere with iron absorption.

Iron Absorption

Iron absorption is a critical step in addressing iron-deficiency anemia. The body regulates iron absorption in the small intestine, and several factors can influence its efficiency. For instance, the iron’s chemical form (heme versus non-heme) affects its bioavailability, with heme iron being more readily absorbed.

Additionally, the presence of other dietary constituents can either promote or inhibit iron uptake. Factors that enhance absorption include the presence of meat, fish, poultry, and—particularly significant—a substance like Vitamin C. On the other hand, some compounds, such as polyphenols and phytates found in some plant-based foods, and calcium-rich foods like dairy, can inhibit iron absorption.

The body is more efficient at absorbing iron in response to decreased body stores or increased physiological demands, such as during growth or pregnancy. Understanding these variables can aid in optimizing the treatment approach for iron-deficiency anemia.

Vitamin C and Iron Uptake

The relationship between Vitamin C and iron uptake is crucial for individuals with iron-deficiency anemia taking oral iron supplements. Vitamin C, or ascorbic acid, acts as a potent enhancer of iron absorption, particularly for non-heme iron sources like those found in supplements and plant-based foods.

Vitamin C accomplishes this by reducing iron from its ferric (Fe3+) to ferrous (Fe2+) state, which is more soluble and easier for the body to absorb. It also binds to non-heme iron, forming a chelate that remains soluble even at the higher pH levels found in the small intestine, where absorption takes place.

Therefore, consuming Vitamin C-rich foods or drinks like orange juice in conjunction with taking an oral iron supplement can significantly improve the supplement's effectiveness. Not only does this facilitate greater iron uptake, but it also helps to replenish the body's iron stores more quickly, addressing the symptoms of anemia and enhancing overall health.