A nurse in a provider's office is caring for a client. Exhibits The nurse reviews the client’s medical record. Click to indicate whether the provider prescription is anticipated, nonessential, or contraindicated for the client.

Administer an iron supplement: Client has iron-deficiency anemia evidenced by low hemoglobin, hematocrit, and ferritin. Iron supplementation is first-line therapy, especially for clients with vegan diets who lack dietary iron. Restrict fluid intake: This is contraindicated for this client. There is no evidence of fluid overload, CHF, or renal failure requiring restriction. Fluid restriction could worsen fatigue, hypotension, and perfusion. Place the client on a low sodium diet: This is not critical for current anemia management. May be beneficial for long-term hypertension management, but not directly related to anemia treatment. Refer for a nutritional consult: Client follows a vegan diet and is at risk for iron and B12 deficiency. A dietitian can provide guidance on iron-rich plant foods, B12 supplementation, and balanced nutrition.