A client with iron deficiency anemia is scheduled for discharge. Which instruction about prescribed ferrous gluconate therapy should the nurse include in the teaching plan?
A. “Take the medication with an antacid.”
B. “Take the medication with a glass of milk.”
C. “Take the medication with cereal.”
D. “Take the medication on an empty stomach.”
Correct Answer: D. “Take the medication on an empty stomach.”
Preferably, ferrous gluconate should be taken on an empty stomach. For best absorption, the recommendation is to take iron at least 30 minutes before a meal or 2 hours before taking other medications. Oral iron replacement therapy is the most cost-effective and readily available for the general public as ferrous sulfate (20% elemental iron), ferrous gluconate (12% elemental iron), and ferrous fumarate (33% elemental iron).
Option A: If the patient cannot tolerate the gastrointestinal side effects, they may take it with small amounts of food. Avoid taking it with milk, calcium, and antacids, high fiber foods, or caffeine. Lab Work consistent with iron deficiency includes low serum iron levels, low transferrin saturation, and a high total iron-binding capacity (TIBC). For patients receiving oral iron, patients will need to return to the office for repeat bloodwork to monitor tolerability to the medication and will need to be on supplementation for months.
Option B: Some studies have suggested taking iron with orange juice or with vitamin C supplementation to help improve absorption. The most common side effects are gastrointestinal, such as nausea/vomiting, constipation or diarrhea, flatulence, metallic taste, staining of the teeth, or epigastric distress.
Option C: Ferrous gluconate should not be taken with antacids, milk, or whole-grain cereals because these foods reduce iron absorption. Patients can decrease the adverse effects by taking iron supplements on an adjusted regimen (i.e., three times a week instead of daily), or taking it with food, although this may de
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