The client had stomach cancer and a surgical removal of his stomach several years ago. The physician prescribed cyanocobalamin (Nascobal). The client stopped this drug several months ago. What will the nurse most likely assess in this client?
1. Memory loss, numbness in the limbs, and depression
2. A gradual decrease in red blood cell counts
3. Jaundice and tarry stools
4. Low hemoglobin and hematocrit counts
1
Rationale 1: The most common cause of vitamin B12 deficiency (pernicious anemia) is absence of intrinsic factor, a protein secreted by stomach cells. This protein is required for vitamin B12 to be absorbed from the intestine. Symptoms of pernicious anemia involve the nervous system and include memory loss, confusion, tingling or numbness in the limbs, and mood disturbances.
Rationale 2: A decrease in red blood cells does not occur with pernicious anemia.
Rationale 3: Jaundice and tarry stools do not occur with pernicious anemia.
Rationale 4: Low hemoglobin and hematocrit counts do not occur with pernicious anemia.
Global Rationale: The most common cause of vitamin B12 deficiency (pernicious anemia) is absence of intrinsic factor, a protein secreted by stomach cells. This protein is required for vitamin B12 to be absorbed from the intestine. Symptoms of pernicious anemia involve the nervous system and include memory loss, confusion, tingling or numbness in the limbs, and mood disturbances. A decrease in red blood cells, jaundice, tarry stools, and low H&H do not occur with pernicious anemia.
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