# A nurse is caring for a client with iron-deficiency anemia. Which nursing intervention should be prioritized to optimize iron absorption? > source: MyMerci (mymerci.kr) > url: https://mymerci.kr/pages/nclex_q.php?qn_id=540777 > language: ko > subject: Adult Health ## 문제 A nurse is caring for a client with iron-deficiency anemia. Which nursing intervention should be prioritized to optimize iron absorption? ## 보기 1. Administer iron supplements with milk to reduce gastric irritation 2. Encourage the client to take iron supplements with coffee or tea 3. Advise the client to take iron supplements with vitamin C-rich foods **✔ 정답** 4. Recommend taking iron supplements immediately after meals **정답: 3** ## 해설 Vitamin C enhances iron absorption by converting ferric iron to ferrous iron, which is more readily absorbed. Other options (milk, coffee/tea) contain substances that inhibit absorption. ## 심화 해설 Understanding Iron Absorption in Iron-Deficiency Anemia The core principle guiding this intervention is the significant impact of dietary timing and co-factors on the bioavailability of oral iron. The provided evidence directly demonstrates that food intake immediately before iron administration substantially reduces absorption. Therefore, the priority is to identify the strategy that actively enhances absorption to correct the deficiency efficiently. Analysis of the Correct Answer Option 3 is correct. Vitamin C (ascorbic acid) is a potent enhancer of non-heme iron absorption, which is the form found in most oral supplements and plant-based foods. It acts by reducing ferric iron (Fe³⁺) to the more soluble and absorbable ferrous form (Fe²⁺) in the duodenum's alkaline environment, preventing it from forming insoluble complexes. This chemical reduction keeps the iron soluble and available for uptake by enterocytes. The study by Komatsu et al. (2026) reinforces the critical need to maximize absorption by showing how easily it is compromised by other factors, making the proactive use of an enhancer like vitamin C a clinical priority [1]. Analysis of Incorrect Answers Option 1: Administering iron with milk is contraindicated. Milk contains calcium and casein phosphopeptides, which are potent inhibitors of iron absorption. Calcium competes with iron for the divalent metal transporter 1 (DMT1) on the apical membrane of enterocytes, directly blocking its uptake. This would further reduce the already limited absorption. Option 2: Coffee and tea contain polyphenols, specifically tannins, which form insoluble, non-absorbable complexes with iron in the gastrointestinal lumen. This chelation effect is a powerful inhibitor of absorption and would directly counteract the therapeutic goal of the supplement. Option 4: This is the most critical distractor and is directly refuted by the provided evidence. The study by Komatsu et al. (2026) found that iron absorption after administering an oral iron preparation "following a meal is generally reduced compared with fasting" [1]. The research specifically investigated administration under fed conditions (immediately after a meal) and confirmed a reduction in absorption. For optimal absorption, oral iron is best administered on an empty stomach, typically one hour before or two hours after a meal, unless significant gastrointestinal intolerance occurs. The study's finding that food impairs absorption makes this option the opposite of the correct priority.References (research sources) - [1]Effect of food on iron absorption in patients with iron deficiency anemia treated with ferric citrate hydrate.Research articleKomatsu N, Ito K, Arita K, Mitobe Y, Mitsui H. (2026) · DOI: 10.1007/s12185-025-04108-8 ## 임상 시나리오 Clinical Guide: Optimizing Oral Iron AbsorptionMaximizing Bioavailability in Iron-Deficiency Anemia Administer oral iron supplements with vitamin C (e.g., a glass of orange juice) to enhance absorption. Vitamin C reduces ferric iron to the absorbable ferrous form. Instruct the client to take iron on an empty stomach, ideally 1 hour before or 2 hours after meals. Food significantly reduces absorption. CautionAvoid concurrent intake with milk, calcium supplements, coffee, or tea. Calcium competes for uptake, and tannins form insoluble complexes with iron. ## 핵심 개념 - **Iron Absorption** — The process primarily occurring in the duodenum where ferrous iron (Fe²⁺) is taken up by enterocytes via the DMT1 transporter. - **Vitamin C (Ascorbic Acid)** — A potent enhancer of non-heme iron absorption that reduces ferric iron (Fe³⁺) to the more soluble ferrous form (Fe²⁺). - **Divalent Metal Transporter 1 (DMT1)** — The primary transporter protein on the apical membrane of enterocytes responsible for the uptake of ferrous iron and other divalent metals. - **Tannins** — Polyphenolic compounds found in tea and coffee that bind to iron, forming insoluble complexes that prevent absorption. - **Non-Heme Iron** — The form of iron found in plant-based foods and most supplements, whose absorption is significantly influenced by dietary enhancers and inhibitors. ## 같은 주제 문제 - [A nurse is assessing a 28-year-old female client who reports fatigue and weakness for the …](https://mymerci.kr/pages/nclex_q.php?qn_id=540773) - [A nurse is assessing a 28-year-old female client with suspected iron-deficiency anemia. Wh…](https://mymerci.kr/pages/nclex_q.php?qn_id=540774) - [A nurse is assessing a 65-year-old male client with iron-deficiency anemia. Which laborato…](https://mymerci.kr/pages/nclex_q.php?qn_id=540775) - [A nurse is caring for a 28-year-old female client diagnosed with iron-deficiency anemia (h…](https://mymerci.kr/pages/nclex_q.php?qn_id=540776) - [A nurse is assessing a 3-year-old child with suspected iron-deficiency anemia. Which asses…](https://mymerci.kr/pages/nclex_q.php?qn_id=542170) - [A nurse is assessing a 2-year-old toddler with suspected iron-deficiency anemia. Which ass…](https://mymerci.kr/pages/nclex_q.php?qn_id=542171) --- More free questions: [기출문제](https://mymerci.kr/) _학습 참고용입니다. 실제 임상은 최신 지침과 소속 기관 프로토콜을 따르세요._