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Nursing QUESTION #9128
Question 1
A pregnant woman at 32 weeks has Hb 7.8 g/dL, MCV 72 fL, serum ferritin 6 ng/mL. She is started on oral iron therapy. The expected rise in hemoglobin after 4 weeks of adequate iron therapy is approximately:
  • 0.5 g/dL
  • 1 g/dL
  • 2 g/dL✔️
  • 4 g/dL
Correct Answer Explanation

This patient has Iron Deficiency Anemia (IDA) of pregnancy, indicated by:

  • Low Hb: \(7.8\,\text{g/dL}\) (normal in pregnancy \(\geq 11\,\text{g/dL}\))
  • Low MCV: \(72\,\text{fL}\) (microcytic; normal \(80{-}100\,\text{fL}\))
  • Low ferritin: \(6\,\text{ng/mL}\) (normal \(>12\,\text{ng/mL}\))

With adequate oral iron supplementation (elemental iron \(100{-}200\,\text{mg/day}\)):

  • Reticulocyte response begins in 3–5 days
  • Hemoglobin rises approximately \(1\,\text{g/dL}\) per week or \(\approx 2\,\text{g/dL}\) in 3–4 weeks
  • Full correction takes 6–8 weeks
  • Iron stores replenished over 3–6 months

If Hb does not rise by \(\geq 1\,\text{g/dL}\) after 4 weeks, consider: non-compliance, malabsorption, wrong diagnosis, or continued blood loss. IV iron is indicated if oral not tolerated or \(<28\) weeks with severe anemia.