A 50-year-old woman who underwent restrictive/malabsorptive surgery with a biliopancreatic diversion about one year earlier demonstrated a distinct attitude change from previous visits when she arrived at the clinic
Instead of being friendly, she was argumentative with staff and other patients. The nurse reviewed her history and found that she had stopped taking the vitamin and mineral supplements prescribed post surgery. She suspected that the problem was caused by: 1. Vitamin B-3 deficiency that resulted in Pellagra.
2. Vitamin B-6 deficiency that resulted in increased stress.
3. Vitamin D deficiency that results in bone demineralization.
4. Vitamin C deficiency that resulted in wet beri beri.
1
Rationale: Restrictive surgery can decrease absorption of vitamins and minerals in the diet including niacin, the cause of Pellagra. Although vitamins B-6, D, and C are essential components of a balanced nutritional intake, deficiencies will not result in changes of the client's emotional status.
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