What is the daily dose of Iron Folic in a pregnant woman with normal Haemoglobin and for how long should it b… - NHM MP Staff Nurse-2019

NHM MP Staff Nurse-2019

Obstetrics & Gynaecology

Medium

Appeared in: NHM MP Staff Nurse-2019

Explanation

For a pregnant woman with normal hemoglobin, the standard prophylactic dose is one IFA tablet per day.
The recommended duration is for at least 6 months (or 180 days) during the pregnancy, typically starting in the second trimester.
This regimen is designed to meet the increased physiological demands for iron and folate during pregnancy, preventing the development of anemia.
National health programs, like India's Anemia Mukt Bharat strategy, recommend this dose and duration for all pregnant women.

Option A: While the daily dose of 1 tablet is correct for prophylaxis, a duration of only 3 months is insufficient to build and maintain adequate iron stores throughout the entire pregnancy and prepare for blood loss during delivery.
Option B: A dose of 2 tablets of IFA per day is a therapeutic dose intended for treating diagnosed iron-deficiency anemia (when hemoglobin is low), not for prophylaxis in a woman with normal hemoglobin.
Option D: This option provides an incorrect dose (2 tablets) and an arbitrary duration (5 months). Two tablets daily is a therapeutic dose, which is unnecessary and potentially causes more side effects for a woman with normal hemoglobin.

Clinical Relevance

Nursing practice connection: Use the key finding related to Prophylactic Iron and Folic Acid (IFA) supplementation during pregnancy to guide bedside assessment, documentation, and the next nursing action.
Nurses play a vital role in antenatal care by educating pregnant women on the importance of IFA supplementation to prevent maternal anemia, low birth weight, and other complications.
Counseling on managing side effects like nausea and constipation is crucial for ensuring patient adherence to the full 180-day course.
What if the woman's hemoglobin was 9.5 g/dL? In that case, she would be diagnosed with mild anemia, and the correct regimen would be therapeutic: 2 IFA tablets daily until her hemoglobin normalizes, after which she would switch to the prophylactic dose of 1 tablet daily.

How to Approach the Question

First, identify the key clinical parameter in the question: 'normal Haemoglobin'.
Recognize that 'normal Haemoglobin' implies the need for a prophylactic (preventive) regimen, not a therapeutic (treatment) one.
Recall the standard national guidelines for prophylactic IFA supplementation in pregnancy.
Evaluate each option based on the standard dose (1 tablet/day) and duration (at least 180 days or 6 months).
Eliminate options with a therapeutic dose (2 tablets/day) or insufficient duration (3 months).

Concept Tested & Keywords

Concept Tested: Prophylactic Iron and Folic Acid (IFA) supplementation during pregnancy.
Stem keywords: daily dose, Iron Folic, pregnant woman, normal Haemoglobin, duration
Lead-in keywords: What is
Clinical cues: The key cue is 'normal Haemoglobin', which indicates the need for a prophylactic (preventive) dose, not a therapeutic (treatment) dose.

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E6 Comprehensive Textbook of Community Health Nursing for BSc Nursing Students Part 2 — Subpart A (pp 1-275 of 550) p. 202-204