Brett has just been diagnosed with pernicious anemia. He comes to you, as the physician's nurse, to give him more information. Discuss the diagnosis of pernicious anemia
a. What is the client lacking to have this disorder?
b. What does the body need for nutrition that it is unable to get and why?
c. Explain the etiology and pathophysiology of this disorder.
d. How is this disorder diagnosed?
e. What would you expect to see for signs and symptoms?
f. What is the medical management and nursing considerations for this type of client?
Students' answers should include the following:
a. Intrinsic factor
b. Inability to absorb vitamin B12, which is required for erythrocyte maturation
c. Degenerative changes in the nervous system; permanent damage if not promptly treated
d. Diagnosis with history, physical, and bone marrow studies
Schilling test and microscopic exam of RBCs
e. Stomatitis, glossitis, digestive issues, jaundice, confusion, and depression
Numbness, tingling in arms and legs, and ataxia with neurologic involvement
f. Lifetime therapy of vitamin B12 IM
Soft, bland diet for glossitis and stomatitis
Physical therapy and prevention of contractures and pressure ulcers due to immobility
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