Let’s use a non-smoking pregnant woman in her first trimester, which is the first box in the upper left corner, to learn about what actions you’ll need to take if your client’s hemoglobin value is low.

Let’s say you run a hemoglobin test on this client and get a value of 10.5, which is below the Anemia cutoff value of 10.9. In this situation, you would assign the risk, ‘201-Anemia’ and counsel her on improving her iron intake & absorption, such as by eating iron-rich foods.

If, however, the value you received was 8.3, which is just below the Nutritionist cutoff value of 8.5, a second test must be run, preferably on the other hand and by another WIC staff member.  When the second test is complete, record the higher of the two test values.

If this second value is still at or below the ‘Nutritionist’ range, assign the risk, ‘201- Anemia’, and educate your client by letting her know that WIC screens for anemia, and doesn’t diagnose it, and since her value is outside of WIC’s normal range, you are going to need to refer her to the nutritionist for further evaluation.

So to recap, assigning risk, counseling your client, running a second test, and referring your client to the nutritionist are the possible actions you’ll need to take, depending upon how low your client’s hemoglobin value is.