The nurse is admitting a client with folic acid deficiency anemi a. Which of the following questions is most important for the nurse to ask the…

Chronic alcohol consumption is a primary cause of folic acid deficiency anemia. Alcohol interferes with the intestinal absorption of folate, increases its excretion by the kidneys, and impairs its metabolism within the body. Furthermore, individuals with chronic alcoholism often have poor dietary intake, further reducing their folate levels. Therefore, assessing for regular alcohol use is the most critical step in identifying the likely etiology of this client's condition and planning appropriate interventions, which include both supplementation and addressing the underlying alcohol use.

A. “Do you take aspirin on a regular basis?”

Regular aspirin use can cause gastrointestinal bleeding, leading to iron deficiency anemia, not folic acid deficiency anemia.

C. “Do you eat red meat?”

Red meat is a primary source of vitamin B12 and iron; its absence is more indicative of pernicious or iron deficiency anemia.

D. “Have your stools been normal?”

Abnormal stools (e.g., melena) suggest gastrointestinal bleeding, a cause of iron deficiency anemia, not typically folic acid deficiency.

1. Lewis, S. L., Bucher, L., Heitkemper, M. M., & Harding, M. M. (2020). Medical-surgical nursing: Assessment and management of clinical problems (11th ed.). Elsevier. In Chapter 30, Hematologic Problems, under the section "Megaloblastic Anemias," the text identifies chronic alcoholism as a common cause of folic acid deficiency due to its interference with folate absorption and metabolism (p. 621).

2. National Institutes of Health, Office of Dietary Supplements. (2022). Folate: Fact Sheet for Health Professionals. In the section "Groups at Risk of Folate Inadequacy," people with alcohol use disorder are listed as a primary risk group because alcohol interferes with folate absorption and increases its excretion.

3. Green, R., & Dwyre, D. M. (2015). The megaloblastic anemias. In K. J. Kaushansky, M. A. Lichtman, J. T. Prchal, M. M. Levi, O. W. Press, L. J. Burns, & M. Caligiuri (Eds.), Williams Hematology (9th ed.). McGraw-Hill Education. Chapter 44 discusses the pathophysiology, stating that alcoholism is one of the most common causes of folate deficiency in the Western world.