The client has chronic alcoholism. He asks the nurse why his doctor put him on folic acid (Folvite) since he promised the doctor that he would stop drinking. What is the best response by the nurse?
1. "You should ask your doctor since you promised him that you would not drink anymore."
2. "You have been drinking instead of eating, and alcohol interferes with folate metabolism in your liver."
3. "You need folic acid to make up for the vitamin B12 deficiency that was caused by your alcoholism."
4. "You need folic acid because you have not been compliant with taking your vitamins and attending Alcoholics Anonymous (AA) meetings."
2
Rationale 1: Referring the client back to the physician is inappropriate; the nurse can answer this question.
Rationale 2: Insufficient folic acid can manifest itself as anemia. This is often observed in chronic alcoholism, since alcoholics consume alcohol instead of eating nutritious foods. Alcohol interferes with folate metabolism in the liver.
Rationale 3: Folic acid anemia is not caused by a vitamin B12 deficiency.
Rationale 4: The client needs folic acid because his liver cannot metabolize folate, not because he has missed his vitamins and Alcoholics Anonymous (AA) meetings.
Global Rationale: Insufficient folic acid can manifest itself as anemia. This is often observed in chronic alcoholism, since alcoholics consume alcohol instead of eating nutritious foods. Alcohol interferes with folate metabolism in the liver. Referring the client back to the physician is inappropriate; the nurse can answer this question. Folic acid anemia is not caused by a vitamin B12 deficiency. The client needs folic acid because his liver cannot metabolize folate, not because he has missed his vitamins and Alcoholics Anonymous (AA) meetings.
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